Abstract
Objective
The purpose of this article was to summarize the available evidence from systematic reviews on telerehabilitation in physical therapy.
Methods
We searched Medline/PubMed, EMBASE, ...and Cochrane Library databases. In addition, the records in PROSPERO and Epistemonikos and PEDro were consulted. Systematic reviews of different conditions, populations, and contexts—where the intervention to be evaluated is telerehabilitation by physical therapy—were included. The outcomes were clinical effectiveness depending on specific condition, functionality, quality of life, satisfaction, adherence, and safety. Data extraction and risk of bias assessment were carried out by a reviewer with non-independent verification by a second reviewer. The findings are reported qualitatively in the tables and figures.
Results
Fifty-three systematic reviews were included, of which 17 were assessed as having low risk of bias. Fifteen reviews were on cardiorespiratory rehabilitation, 14 on musculoskeletal conditions, and 13 on neurorehabilitation. The other 11 reviews addressed other types of conditions and rehabilitation. Thirteen reviews evaluated with low risk of bias showed results in favor of telerehabilitation versus in-person rehabilitation or no rehabilitation, while 17 reported no differences between the groups. Thirty-five reviews with unclear or high risk of bias showed mixed results.
Conclusions
Despite the contradictory results, telerehabilitation in physical therapy could be comparable with in-person rehabilitation or better than no rehabilitation for conditions such as osteoarthritis, low-back pain, hip and knee replacement, and multiple sclerosis and also in the context of cardiac and pulmonary rehabilitation. It is imperative to conduct better quality clinical trials and systematic reviews.
Impact
Providing the best available evidence on the effectiveness of telerehabilitation to professionals, mainly physical therapists, will impact the decision-making process and therefore yield better clinical outcomes for patients, both in these times of the COVID-19 pandemic and in the future. The identification of research gaps will also contribute to the generation of relevant and novel research questions.
Stroke is the most common specific cause of death in Chile since 2008, representing roughly 10% of total deaths in the country.
To analyze hospital discharges with a diagnosis of stroke in the period ...2001-2010 in a regional Chilean health service.
Analysis of hospital discharge databases of the department of statistics and health information (DEIS) of the Chilean Ministry of Health for the years 2001-2010. All subjects aged over 15 years and discharged with a diagnosis of stroke during the period 2001-2010 in a southern Chilean region, were included in the study.
In the period, 6,548 hospital discharges due to stroke were registered. The most common diagnoses were ischemic and hemorrhagic stroke, followed by intracranial hemorrhage. Hospital stay fluctuated between one and ten days in 77% of patients. The incidence rate of stroke as a discharge diagnosis was 961.3 per 100,000 population per year (95% Confidence intervals 950.7- 972.4).
The information collected allows updating the information regarding hospital discharges due to stroke in the region studied.
Motivated by the need of data on neutron-induced reactions with biologically relevant materials, e.g., carbon and oxygen, we have constructed and installed the MEDLEY detector array at the neutron ...beam facility of the The Svedberg Laboratory in Uppsala. The central detection elements of MEDLEY are three-detector telescopes, consisting of two silicon detectors and a Csl crystal. To cover wide energy and angle ranges, we have mounted eight such telescopes at 20° intervals. We have used ΔE − ΔE − E techniques to obtain good particle identification for protons, deuterons, tritons,
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He and α particles over an energy range from a few MeV up to 100 MeV. To define the detector solid angle, plastic scintillators were employed to serve as active collimators.
We have up to now measured double-differential cross sections of inclusive light-ion production induced by 95 MeV neutrons on carbon and oxygen. From these data production cross sections, as well as partial kerma coefficients, are being determined. We have found that especially the proton kerma coefficient for carbon is substantially larger than that of a recent evaluation, leading to a larger total kerma coefficient. The obtained data supports a trend observed for similar data at lower energies.
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