OBJECTIVE: To propose and evaluate the effectiveness of a telerehabilitation platform designed for patients with rotator cuff (RC) tears. METHODS: During the first study phase, a virtual service platform that included information on RC tear pathology, joint care, and a series of instructions regarding therapeutic exercise was designed and created. Subsequently, in the clinical phase, a quasi-experimental study was performed. The platform was tested on patients and evaluated at baseline and at 1, 2, 3, and 6 months with respect to their pain levels and functionality on the Constant-Murley (CM) scale. RESULTS: Eleven patients were included, 5 women and 6 men, with a median age of 55 years (range, 42–68 years). Pain diminished from a baseline value of 64 mm (range, 40–80 mm) to 16 mm (range, 0–30 mm) at 6 months (p<0.001). Points on the CM scale rose from a baseline value of 54 points (range, 51–66 points) to 85 points (range, 70–100 points) at 6 months (p=0.001). Functionality in daily living and work activities, movement, and strength exhibited significant changes at 6 months (p<0.05). CONCLUSION: Significant changes were observed in pain and functionality in this group of participants who used a telerehabilitation platform. To the best of our knowledge, this is the first study that included a specific program for RC tears.
Female ; Humans ; Joints ; Male ; Non-Randomized Controlled Trials as Topic ; Pathology ; Rehabilitation ; Remote Consultation ; Rotator Cuff* ; Shoulder ; Tears* ; Telemedicine ; Telerehabilitation*

The suspension of facility-based rehabilitation services and restricted mobility at the onslaught of the coronavirus disease 2019 (COVID-19) pandemic forced healthcare workers to explore new methods of providing patient care. This case report presents a 40-year-old female who underwent osteotomy with iliac crest bone graft and intramedullary nailing with quadricepsplasty to correct the leg length discrepancy and knee extension contracture that developed secondary to multiple bone injuries sustained in a vehicular accident 17 months before admission. The in-hospital postoperative rehabilitation was prematurely terminated due to the COVID-19 lockdown. The client was discharged with pain and swelling of the right lower limb, knee flexion of 0–25°, and an ankle plantar flexion contracture. She had moderate to severe difficulty in walking, bathing, toileting, and lower garment dressing, needing assistance to complete these tasks. Telerehabilitation was done over three months using both synchronous and asynchronous methods. Gains from the remote program were independence in all the self-care activities with no difficulty in performing them. The patient was able to return to work. Gains in knee and ankle mobility were minimal. Telerehabilitation using available technologies can be used to continue patient care amidst barriers to face-to-face rehabilitation in a low-resource country
Telerehabilitation ; Telemedicine ; COVID-19 ; Osteotomy

Background: Catalyzed by the coronavirus disease 2019 (COVID-19) pandemic that restricted non-essential travel, awareness of the value of telehealth increased among healthcare providers and consumers. Telerehabilitation, a subset of telehealth and telemedicine, refers explicitly to the remote provision of rehabilitation services. However, since the majority were new to the concept of telerehabilitation, which was commonly interchanged with other related terms (e.g., telehealth, telemedicine, teletherapy, telecare, telepractice, etc.), and relevant internationally recognized guidelines were not available pre-pandemic, many turned to online resources to learn more about it. However, such might create confusion with the terminologies. Objective: This infodemiological study aimed to examine the trends of global online interest in telehealth, telemedicine, telerehabilitation, and related search terms. The authors hypothesized an abrupt rise in stakeholders' awareness regarding the virtual method of delivering or accessing healthcare, including rehabilitation services, during the pandemic. Method: Using Google Trends™, we obtained and analyzed the trends of global online interest in telehealth, telemedicine, telerehabilitation, and other related search terms from 2004 to October 2020. Results: The frequencies of searches for “telehealth,” “telemedicine,” and “telerehabilitation” peaked in March 2020, which coincided with the lockdown in many countries, including the Philippines. The term “telehealth” was more frequently searched in western countries, while “telemedicine” was relatively common in eastern countries. Among the terms synonymous with telerehabilitation, “teletherapy” was most commonly used worldwide, with “teletherapy speech” being the most searched related topic. The Philippines had the most significant number of times the term “telerehabilitation” was searched in the past decade. Conclusion During the COVID-19 pandemic, there is an overall global demand for the acquisition of knowledge related to telehealth, telemedicine, telerehabilitation, and related search terms. Of particular interest, tele rehabilitation, however, varied in terminologies across countries, with “teletherapy” mainly being used worldwide and “telerehabilitation” being primarily searched in the Philippines. Therefore, arriving at a consensus across professional societies and operationally defining different interrelated terms could help streamline our current or future guidelines and programs.
Telemedicine ; Telerehabilitation ; COVID-19 ; Infodemiology

Introduction: The coronavirus disease 2019 (COVID-19) pandemic prompted a shift from standard in-person consultation to non-patient contact methods such as telemedicine. To our knowledge, there was no published a priori evaluation of the telemedicine readiness and acceptance among the medical staff of the Philippine General Hospital (PGH) before implementing the institution’s telemedicine program. The lack of this vital pre-implementation step is understandable given the unprecedented crisis. However, if telemedicine programs will continue in the post-quarantine period, it is crucial to determine the facilitators and barriers to the use of telemedicine. Objective: This study determined the level of readiness and acceptance for telemedicine as an alternative method for patient consultation during the COVID-19 pandemic and post-enhanced community quarantine period among PGH medical staff (consultants, residents, fellows). Methods: The cross-sectional study was conducted from October 2020 to July 2021. Medical staff from the 16 clinical departments of the PGH were selected by systematic random sampling. Inclusion criteria included appointment as medical staff in PGH or University of the Philippines College of Medicine (UPCM), voluntary informed consent, internet access, and technical capacity to access e-mail and SurveyMonkey™. The online survey consisted of two questionnaires. It collected data on the demographic profile and outcomes of interest (e.g., telemedicine readiness and acceptance). Technological readiness was determined through the 16-item modified version of Technological Readiness Index (TRI) version 2.0, while telemedicine acceptance was determined through the modified version of the 19-item Unified Theory of Acceptance and Use of Technology (UTAUT) questionnaire. Descriptive and analytical statistics were performed at a 95% confidence interval. Results: The study had an 87% response rate with 205 respondents, 62% of whom were physicians in training (resident physicians and fellows). The respondents had a median age of 33 years and were mostly males. Only 19% had telemedicine experience before the pandemic. The majority (51%) learned telemedicine on their own. The most common devices used for telemedicine were mobile or smartphones (53%) and laptops (38%). The primary source of internet for telemedicine was mobile broadband (e.g., cellular data) (40%). The majority practiced telemedicine at their home or residence (51%), followed closely by the hospital or clinic (47%). The mean score of the respondents on TRI was 3.56 (very good technological readiness), and 4.00 (very good telemedicine acceptance) on UTAUT (behavioral intention to use the system). Performance expectancy (p = 0.02), effort expectancy (p = 0.03), and self-efficacy (p = 0.02) were significantly directly related to telemedicine adoption, while anxiety (p = 0.03) was significantly inversely related. Conclusion The PGH medical staff were found to have very good telemedicine readiness and acceptance. This suggests a willingness to use telemedicine during the pandemic. Further studies on the organization and technical support system of the telemedicine program in the PGH are strongly recommended. The quality and efficiency of the program will strongly influence the continued use of telemedicine by the medical staff even after the pandemic.
Health Services Administration ; Telemedicine ; Telecommunications ; Remote Consultation ; COVID-19

The coronavirus disease 2019 (COVID-19) epidemic is evolving in Latin America despite implementation of government measures. We report a familial cluster in Lima, Peru, with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Two young and two middle-aged adults with a wide range of COVID-19 manifestations experienced successful management under telehealth outpatient monitoring. Telehealth monitoring was scheduled as suggested by Peruvian Ministry of Health Guidelines and was performed by a designated physician who assessed the patients and prescribed treatment. On May 14, 2020, a 25-year-old male, who worked treating COVID-19 patients, reported constitutional symptoms and tested positive for SARS-CoV-2. Clinical improvement was achieved with azithromycin and ivermectin therapy. He had been in contact with his parents (Cases 2 and 3) and his sister (Case 4). Cases 2 and 3 developed moderate pulmonary compromise requiring oxygen supplementation and pharmacological therapy, including corticosteroids and anticoagulation, under home medical assessment and telehealth monitoring. Case 4 developed mild symptoms and periorbital rash, an atypical dermatological finding. To our knowledge this represents the first report of a familial cluster with COVID-19 that was successfully managed under scheduled telehealth outpatient monitoring in Latin America.
SARS-CoV-2 ; COVID-19 ; Telemedicine ; Remote Consultation

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Telemedicine*

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Telemedicine

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Telemedicine

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Telemedicine

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Telemedicine*