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BACKGROUND Commercially available active video games (AVGs) have recently been used for rehabilitation in some specific patient populations, but rarely in those with cardiovascular disease (CVD). Commercially available AVGs are designed to increase motivation for continuous play, which could be applicable to the long-term cardiac rehabilitation process. OBJECTIVE The objective of this scoping review was to assess the effectiveness of AVG-induced physical exercise, safety management, and patient adherence by applying commercially available AVGs to cardiac rehabilitation. METHODS Four databases (CINAHL, MEDLINE, PubMed, and SPORTDiscus) were searched for all years up to August 12, 2020. Articles were retained if they were written in English, included patients with CVD who were aged 18 years or older, and used AVGs as part of a physical exercise program. The included studies were then evaluated from the viewpoints of effectiveness as physical exercise, safety, and adherence. RESULTS Among 120 non-duplicate articles reviewed, five were eligible for inclusion, three of which were reported by the same research group. The AVG consoles used were Xbox Kinect and Nintendo Wii, and sports-related programs were adopted for the intervention. No adverse cardiac events occurred in the identified studies, and dropout rates tended to be low. CONCLUSIONS AVGs appear to be a safe and feasible tool for promoting an active lifestyle in patients with CVD. However, the effectiveness of AVGs alone as a therapeutic exercise to improve physical function may be limited.
Ryuichi Sawa; Masakazu Saitoh; Tomoyuki Morisawa; Tetsuya Takahashi; Yuh Morimoto; Nobuyuki Kagiyama; Takatoshi Kasai; Birthe Dinesen; Hiroyuki Daida. Potential of Commercially Available Active Video Game for Application to Cardiac Rehabilitation: A Scoping Review (Preprint). 2021, 1 .
AMA StyleRyuichi Sawa, Masakazu Saitoh, Tomoyuki Morisawa, Tetsuya Takahashi, Yuh Morimoto, Nobuyuki Kagiyama, Takatoshi Kasai, Birthe Dinesen, Hiroyuki Daida. Potential of Commercially Available Active Video Game for Application to Cardiac Rehabilitation: A Scoping Review (Preprint). . 2021; ():1.
Chicago/Turabian StyleRyuichi Sawa; Masakazu Saitoh; Tomoyuki Morisawa; Tetsuya Takahashi; Yuh Morimoto; Nobuyuki Kagiyama; Takatoshi Kasai; Birthe Dinesen; Hiroyuki Daida. 2021. "Potential of Commercially Available Active Video Game for Application to Cardiac Rehabilitation: A Scoping Review (Preprint)." , no. : 1.
Background More than 37 million people worldwide have been diagnosed with heart failure, which is a growing burden on the health sector. Cardiac rehabilitation aims to improve patients’ recovery, functional capacity, psychosocial well-being, and health-related quality of life. However, cardiac rehabilitation programs have poor compliance and adherence. Telerehabilitation may be a solution to overcome some of these challenges to cardiac rehabilitation by making it more individualized. As part of the Future Patient Telerehabilitation program, a digital toolbox aimed at enabling patients with heart failure to monitor and evaluate their own current status has been developed and tested using data from a patient-reported outcome questionnaire that the patient filled in every alternate week for 1 year. Objective The aim of this study is to evaluate the changes in quality of life and well-being among patients with heart failure, who are participants in the Future Patient Telerehabilitation program over the course of 1 year. Methods In total, 140 patients were enrolled in the Future Patient Telerehabilitation program and randomized into either the telerehabilitation group (n=70) or the control group (n=70). Of the 70 patients in the telerehabilitation group, 56 (80.0%) answered the patient-reported outcome questionnaire and completed the program, and these 56 patients comprised the study population. The patient-reported outcomes consisted of three components: (1) questions regarding the patients’ sleep patterns assessed using the Spiegel Sleep Questionnaire; (2) measurements of physical limitations, symptoms, self-efficacy, social interaction, and quality of life assessed using the Kansas City Cardiomyopathy Questionnaire in 10 dimensions; and (3) 5 additional questions regarding psychological well-being that were developed by the research group. Results The changes in scores during 1 year of the study were examined using 1-sample Wilcoxon signed-rank tests. There were significant differences in the scores for most of the slopes of the scores from the dimensions of the Kansas City Cardiomyopathy Questionnaire (P<.05). Conclusions There was a significant increase in clinical and social well-being and quality of life during the 1-year period of participating in a telerehabilitation program. These results suggest that patient-reported outcome questionnaires may be used as a tool for patients in a telerehabilitation program that can both monitor and guide patients in mastering their own symptoms. Trial Registration ClinicalTrials.gov NCT03388918; https://clinicaltrials.gov/ct2/show/NCT03388918
Cathrine Skov Schacksen; Anne-Kirstine Dyrvig; Nanna Celina Henneberg; Josefine Dam Gade; Helle Spindler; Jens Refsgaard; Malene Hollingdal; Lars Dittman; Kim Dremstrup; Birthe Dinesen. Patient-Reported Outcomes From Patients With Heart Failure Participating in the Future Patient Telerehabilitation Program: Data From the Intervention Arm of a Randomized Controlled Trial. JMIR Cardio 2021, 5, e26544 .
AMA StyleCathrine Skov Schacksen, Anne-Kirstine Dyrvig, Nanna Celina Henneberg, Josefine Dam Gade, Helle Spindler, Jens Refsgaard, Malene Hollingdal, Lars Dittman, Kim Dremstrup, Birthe Dinesen. Patient-Reported Outcomes From Patients With Heart Failure Participating in the Future Patient Telerehabilitation Program: Data From the Intervention Arm of a Randomized Controlled Trial. JMIR Cardio. 2021; 5 (2):e26544.
Chicago/Turabian StyleCathrine Skov Schacksen; Anne-Kirstine Dyrvig; Nanna Celina Henneberg; Josefine Dam Gade; Helle Spindler; Jens Refsgaard; Malene Hollingdal; Lars Dittman; Kim Dremstrup; Birthe Dinesen. 2021. "Patient-Reported Outcomes From Patients With Heart Failure Participating in the Future Patient Telerehabilitation Program: Data From the Intervention Arm of a Randomized Controlled Trial." JMIR Cardio 5, no. 2: e26544.
BACKGROUND Heart failure is one of the world’s most frequently diagnosed cardiovascular diseases. An important element of heart failure management is cardiac rehabilitation, which aims to improve patients’ recovery, functional capacity, psychosocial well-being, and health-related quality of life. Patients in cardiac rehabilitation may lack sufficient motivation or feel that the rehabilitation process does not meet their individual needs. One solution to these challenges is the use of telerehabilitation. Although telerehabilitation has been available for several years, it is only in recent years that it has been utilized in heart failure studies. Especially within the past five years, we now have several studies focusing on the effectiveness of telerehabilitation for heart failure management, and the studies show varying results. Based on these studies, this paper provides a review and assessment of the general effectiveness of telerehabilitation as applied to heart failure management. OBJECTIVE The aim of this scoping review is to assess the effects of telerehabilitation in the management of heart failure by systematically reviewing the available scientific literature within the period from January 1st 2015 to December 31st 2020. METHODS The literature search was performed using PubMed and EMBASE. After duplicates were removed, 77 articles were screened and reviewed, of which 12 articles were included in this review. As measures of the effectiveness of telerehabilitation, the following outcomes were used: patient’s quality of life, physical capacity, depression/anxiety, and adherence to the intervention. RESULTS In reviewing the effects of telerehabilitation for heart failure patients, it was found that, 4 out of 6 randomized control trials, the single prospective study, and 4 out of 5 reviews reported increased quality of life for patients. For physical capacity, 4 randomized control trials and 3 systematic reviews revealed increased physical capacity. Depression or depressive symptoms was reported as reduced in 1 of the 6 randomized control trials and in 2 of the 5 reviews. Anxiety or anxiety-related symptoms was only reported as reduced in only 1 review. High adherence to the telerehabilitation program was reported in 4 randomized control trials and 4 reviews. It should be mentioned that some of the reviewed articles described the same studies although they used different outcome measures. CONCLUSIONS Telerehabilitation is still a relatively new approach to heart failure patients. It was found that there is a tendency toward improvement in patients’ quality of life and physical capacity. The outcome measures of depression, anxiety and adherence to the intervention were found to be positive. More research is needed to determine more precise and robust effects on the respective outcomes in telerehabilitation.
Cathrine Skov Schacksen; Nanna Celina Henneberg; Janusiya Anajan Muthulingam; Yuh Morimoto; Ryuichi Sawa; Masakazu Saitoh; Tomoyuki Morisawa; Nobuyuki Kagiyama; Tetsuya Takahashi; Takatoshi Kasai; Hiroyuki Daida; Jens Refsgaard; Malene Hollingdal; Birthe Dinesen. Effects of Telerehabilitation Interventions in Heart Failure 2015-2020: Scoping Review (Preprint). 2021, 1 .
AMA StyleCathrine Skov Schacksen, Nanna Celina Henneberg, Janusiya Anajan Muthulingam, Yuh Morimoto, Ryuichi Sawa, Masakazu Saitoh, Tomoyuki Morisawa, Nobuyuki Kagiyama, Tetsuya Takahashi, Takatoshi Kasai, Hiroyuki Daida, Jens Refsgaard, Malene Hollingdal, Birthe Dinesen. Effects of Telerehabilitation Interventions in Heart Failure 2015-2020: Scoping Review (Preprint). . 2021; ():1.
Chicago/Turabian StyleCathrine Skov Schacksen; Nanna Celina Henneberg; Janusiya Anajan Muthulingam; Yuh Morimoto; Ryuichi Sawa; Masakazu Saitoh; Tomoyuki Morisawa; Nobuyuki Kagiyama; Tetsuya Takahashi; Takatoshi Kasai; Hiroyuki Daida; Jens Refsgaard; Malene Hollingdal; Birthe Dinesen. 2021. "Effects of Telerehabilitation Interventions in Heart Failure 2015-2020: Scoping Review (Preprint)." , no. : 1.
Atrial fibrillation (AF) is the most common cardiac arrhythmia and is predicted to more than double in prevalence over the next 20 years. Tailored patient education is recommended as an important aspect of AF care. Current guidelines emphasize that patients become more active participants in the management of their own disease, yet there are no rehabilitation programs for patients with AF in the Danish health care system. Through participatory design, we developed the Future Patient Telerehabilitation (TR) Programs, A and B, for patients with AF. The 2 programs are based on HeartPortal and remote monitoring, together with educational modules. The aim of this pilot study is to evaluate and compare the feasibility of the 2 programs of TR for patients with AF. This pilot study was conducted between December 2019 and March 2020. The pilot study consisted of testing the 2 TR programs, A and B, in two phases: (1) treatment at the AF clinic and (2) TR at home. The primary outcome of the study was the usability of technologies for self-monitoring and the context of the TR programs as seen from patients' perspectives. Secondary outcomes were the development of patients' knowledge of AF, development of clinical data, and understanding the expectations and experiences of patients and spouses. Data were collected through interviews, questionnaires, and clinical measurements from home monitoring devices. Statistical analyses were performed using the IBM SPSS Statistics version 26. Qualitative data were analyzed using NVivo 12.0. Through interviews, patients articulated the following themes about participating in a TR program: usefulness of the HeartPortal, feeling more secure living with AF, community of practice living with AF, and measuring heart rhythm makes good sense. Through interviews, the spouses of patients with AF expressed that they had gained increased knowledge about AF and how to support their spouses living with AF in everyday life. Results from the responses to the Jessa AF Knowledge Questionnaire support the qualitative data, as they showed that patients in program B acquired increased knowledge about AF at follow-up compared with baseline. No significant differences were found in the number of electrocardiography recordings between the 2 groups. Patients with AF and their spouses were positive about the TR program and they found the TR program useful, especially because it created an increased sense of security, knowledge about mastering their symptoms, and a community of practice linking patients with AF and their spouses and health care personnel. To assess all the benefits of the Future Patient-TR Program for patients with AF, it needs to be tested in a comprehensive randomized controlled trial. ClinicalTrials.gov NCT04493437; https://clinicaltrials.gov/ct2/show/NCT04493437.
Birthe Dinesen; Josefine Dam Gade; Cathrine Skov Schacksen; Helle Spindler; Andi Eie Albertsen; Lars Dittmann; Mads Jochumsen; Dorthe Svenstrup Møller. The Danish Future Patient Telerehabilitation Program for Patients with Atrial Fibrillation: Design and Pilot Study in Collaboration with Patients and Their Spouses (Preprint). JMIR Cardio 2021, 5, e27321 .
AMA StyleBirthe Dinesen, Josefine Dam Gade, Cathrine Skov Schacksen, Helle Spindler, Andi Eie Albertsen, Lars Dittmann, Mads Jochumsen, Dorthe Svenstrup Møller. The Danish Future Patient Telerehabilitation Program for Patients with Atrial Fibrillation: Design and Pilot Study in Collaboration with Patients and Their Spouses (Preprint). JMIR Cardio. 2021; 5 (2):e27321.
Chicago/Turabian StyleBirthe Dinesen; Josefine Dam Gade; Cathrine Skov Schacksen; Helle Spindler; Andi Eie Albertsen; Lars Dittmann; Mads Jochumsen; Dorthe Svenstrup Møller. 2021. "The Danish Future Patient Telerehabilitation Program for Patients with Atrial Fibrillation: Design and Pilot Study in Collaboration with Patients and Their Spouses (Preprint)." JMIR Cardio 5, no. 2: e27321.
BACKGROUND Atrial fibrillation is the most common cardiac arrhythmia and is predicted to more than double in prevalence over the next 20 years. Tailored patient education is recommended as an important aspect of atrial fibrillation care. Current guidelines emphasize measures enabling patients to become more active participants in the management of their own disease, yet there are no rehabilitation programs for AF patients in the Danish healthcare system. OBJECTIVE The aims of this pilot study were to identify the challenges facing patients with atrial fibrillation and their relatives and based upon this, to design and pilot test a telerehabilitation program. METHODS A participatory design process was divided into a phase 0 and a phase 1, and took place from December 2018 to March 2020. Phase 0 consisted of interviews, cultural probes, and workshops with the aim of identifying and prioritizing challenges of living with atrial fibrillation in everyday life as they affect atrial fibrillation patients and their relatives, as well as to design scenarios for telerehabilitation programs for patients with atrial fibrillation. Phase 1 was conducted as a pilot study with the aim to evaluate and compare the feasibility of two scenarios of telerehabilitation programs for atrial fibrillation patients. RESULTS The main results of iterations 1 and 2 were the following challenges listed in a prioritized order: Lack of knowledge of everyday stresses, psychological influence, physical limitations, insecurity about being diagnosed and living with atrial fibrillation, and uncertainty about the role of the relative. In iteration 3, two scenarios of telerehabilitation programs, A and B, were designed, and a web-based interactive HeartPortal for patients with atrial fibrillation was created. In iteration 4, a pilot study of the two telerehabilitation programs was tested and evaluated. CONCLUSIONS Patients with atrial fibrillation and their relatives were positive about a telerehabilitation program. Patients with atrial fibrillation and their relatives found the telerehabilitation program useful, especially because it created an increased sense of security, knowledge about mastering their symptoms and a community of practice linking patients with atrial fibrillation and their relatives and healthcare personnel. CLINICALTRIAL ClinicalTrials.gov NCT04493437; https://clinicaltrials.gov/ct2/show/NCT04493437
Birthe Dinesen; Josefine Dam Gade; Cathrine Skov Schacksen; Helle Spindler; Andi Eie Albertsen; Lars Dittmann; Mads Jochumsen; Dorthe Svenstrup Møller. The Danish Future Patient Telerehabilitation Program for Patients with Atrial Fibrillation: Design and Pilot Study in Collaboration with Patients and Their Relatives (Preprint). 2021, 1 .
AMA StyleBirthe Dinesen, Josefine Dam Gade, Cathrine Skov Schacksen, Helle Spindler, Andi Eie Albertsen, Lars Dittmann, Mads Jochumsen, Dorthe Svenstrup Møller. The Danish Future Patient Telerehabilitation Program for Patients with Atrial Fibrillation: Design and Pilot Study in Collaboration with Patients and Their Relatives (Preprint). . 2021; ():1.
Chicago/Turabian StyleBirthe Dinesen; Josefine Dam Gade; Cathrine Skov Schacksen; Helle Spindler; Andi Eie Albertsen; Lars Dittmann; Mads Jochumsen; Dorthe Svenstrup Møller. 2021. "The Danish Future Patient Telerehabilitation Program for Patients with Atrial Fibrillation: Design and Pilot Study in Collaboration with Patients and Their Relatives (Preprint)." , no. : 1.
BACKGROUND More than 37 million people worldwide have been diagnosed with heart failure, which is a growing burden on the health sector. Cardiac rehabilitation aims to improve patients’ recovery, functional capacity, psychosocial well-being, and health-related quality of life. However, cardiac rehabilitation programs have poor compliance and adherence. Telerehabilitation may be a solution to overcome some of these challenges to cardiac rehabilitation by making it more individualized. As part of the Future Patient Telerehabilitation program, a digital toolbox aimed at enabling patients with heart failure to monitor and evaluate their own current status has been developed and tested using data from a patient-reported outcome questionnaire that the patient filled in every alternate week for 1 year. OBJECTIVE The aim of this study is to evaluate the changes in quality of life and well-being among patients with heart failure, who are participants in the Future Patient Telerehabilitation program over the course of 1 year. METHODS In total, 140 patients were enrolled in the Future Patient Telerehabilitation program and randomized into either the telerehabilitation group (n=70) or the control group (n=70). Of the 70 patients in the telerehabilitation group, 56 (80.0%) answered the patient-reported outcome questionnaire and completed the program, and these 56 patients comprised the study population. The patient-reported outcomes consisted of three components: (1) questions regarding the patients’ sleep patterns assessed using the Spiegel Sleep Questionnaire; (2) measurements of physical limitations, symptoms, self-efficacy, social interaction, and quality of life assessed using the Kansas City Cardiomyopathy Questionnaire in 10 dimensions; and (3) 5 additional questions regarding psychological well-being that were developed by the research group. RESULTS The changes in scores during 1 year of the study were examined using 1-sample Wilcoxon signed-rank tests. There were significant differences in the scores for most of the slopes of the scores from the dimensions of the Kansas City Cardiomyopathy Questionnaire (P<.05). CONCLUSIONS There was a significant increase in clinical and social well-being and quality of life during the 1-year period of participating in a telerehabilitation program. These results suggest that patient-reported outcome questionnaires may be used as a tool for patients in a telerehabilitation program that can both monitor and guide patients in mastering their own symptoms. CLINICALTRIAL ClinicalTrials.gov NCT03388918; https://clinicaltrials.gov/ct2/show/NCT03388918
Cathrine Skov Schacksen; Anne-Kirstine Dyrvig; Nanna Celina Henneberg; Josefine Dam Gade; Helle Spindler; Jens Refsgaard; Malene Hollingdal; Lars Dittman; Kim Dremstrup; Birthe Dinesen. Patient-Reported Outcomes From Patients With Heart Failure Participating in the Future Patient Telerehabilitation Program: Data From the Intervention Arm of a Randomized Controlled Trial (Preprint). 2020, 1 .
AMA StyleCathrine Skov Schacksen, Anne-Kirstine Dyrvig, Nanna Celina Henneberg, Josefine Dam Gade, Helle Spindler, Jens Refsgaard, Malene Hollingdal, Lars Dittman, Kim Dremstrup, Birthe Dinesen. Patient-Reported Outcomes From Patients With Heart Failure Participating in the Future Patient Telerehabilitation Program: Data From the Intervention Arm of a Randomized Controlled Trial (Preprint). . 2020; ():1.
Chicago/Turabian StyleCathrine Skov Schacksen; Anne-Kirstine Dyrvig; Nanna Celina Henneberg; Josefine Dam Gade; Helle Spindler; Jens Refsgaard; Malene Hollingdal; Lars Dittman; Kim Dremstrup; Birthe Dinesen. 2020. "Patient-Reported Outcomes From Patients With Heart Failure Participating in the Future Patient Telerehabilitation Program: Data From the Intervention Arm of a Randomized Controlled Trial (Preprint)." , no. : 1.
Measuring respiration at home for cardiac patients, a simple method that can detect the patient’s natural respiration, is needed. The purpose of this study was to develop an algorithm for estimating the tidal volume (TV) and respiratory rate (RR) from the depth value of the chest and/or abdomen, which were captured using a depth camera. The data of two different breathing patterns (normal and deep) were acquired from both the depth camera and the spirometer. The experiment was performed under two different clothing conditions (undressed and wearing a T-shirt). Thirty-nine elderly volunteers (male = 14) were enrolled in the experiment. The TV estimation algorithm for each condition was determined by regression analysis using the volume data from the spirometer as the objective variable and the depth motion data from the depth camera as the explanatory variable. The RR estimation was calculated from the peak interval. The mean absolute relative errors of the estimated TV for males were 14.0% under undressed conditions and 10.7% under T-shirt-wearing conditions; meanwhile, the relative errors for females were 14.7% and 15.5%, respectively. The estimation error for the RR was zero out of a total of 206 breaths under undressed conditions and two out of a total of 218 breaths under T-shirt-wearing conditions for males. Concerning females, the error was three out of a total of 329 breaths under undressed conditions and five out of a total of 344 breaths under T-shirt-wearing conditions. The developed algorithm for RR estimation was accurate enough, but the estimated occasionally TV had large errors, especially in deep breathing. The cause of such errors in TV estimation is presumed to be a result of the whole-body motion and inadequate setting of the measurement area.
Wakana Imano; Kenichi Kameyama; Malene Hollingdal; Jens Refsgaard; Knud Larsen; Cecilie Topp; Sissel Højsted Kronborg; Josefine Dam Gade; Birthe Dinesen. Non-Contact Respiratory Measurement Using a Depth Camera for Elderly People. Sensors 2020, 20, 6901 .
AMA StyleWakana Imano, Kenichi Kameyama, Malene Hollingdal, Jens Refsgaard, Knud Larsen, Cecilie Topp, Sissel Højsted Kronborg, Josefine Dam Gade, Birthe Dinesen. Non-Contact Respiratory Measurement Using a Depth Camera for Elderly People. Sensors. 2020; 20 (23):6901.
Chicago/Turabian StyleWakana Imano; Kenichi Kameyama; Malene Hollingdal; Jens Refsgaard; Knud Larsen; Cecilie Topp; Sissel Højsted Kronborg; Josefine Dam Gade; Birthe Dinesen. 2020. "Non-Contact Respiratory Measurement Using a Depth Camera for Elderly People." Sensors 20, no. 23: 6901.
Background Physical activity has been shown to decrease cardiovascular mortality and morbidity. Walking, a simple physical activity which is an integral part of daily life, is a feasible and safe activity for patients with heart failure (HF). A step counter, measuring daily walking activity, might be a motivational factor for increased activity. Objective The aim of this study was to examine the association between walking activity and demographical and clinical data of patients with HF, and whether these associations could be used as predictors of walking activity. Methods A total of 65 patients with HF from the Future Patient Telerehabilitation (FPT) program were included in this study. The patients monitored their daily activity using a Fitbit step counter for 1 year. This monitoring allowed for continuous and safe data transmission of self-monitored activity data. Results A higher walking activity was associated with younger age, lower New York Heart Association (NYHA) classification, and higher ejection fraction (EF). There was a statistically significant correlation between the number of daily steps and NYHA classification at baseline (P=.01), between the increase in daily steps and EF at baseline (P<.001), and between the increase in daily steps and improvement in EF (P=.005). The patients’ demographic, clinical, and activity data could predict 81% of the variation in daily steps. Conclusions This study demonstrated an association between demographic, clinical, and activity data for patients with HF that could predict daily steps. A step counter can thus be a useful tool to help patients monitor their own physical activity. Trial Registration ClinicalTrials.gov NCT03388918; https://clinicaltrials.gov/ct2/show/NCT03388918 International Registered Report Identifier (IRRID) RR2-10.2196/14517
Josefine Dam Gade; Helle Spindler; Malene Hollingdal; Jens Refsgaard; Lars Dittmann; Lars Frost; Kiomars Mahboubi; Birthe Dinesen. Predictors of Walking Activity in Patients With Systolic Heart Failure Equipped With a Step Counter: Randomized Controlled Trial. JMIR Biomedical Engineering 2020, 5, e20776 .
AMA StyleJosefine Dam Gade, Helle Spindler, Malene Hollingdal, Jens Refsgaard, Lars Dittmann, Lars Frost, Kiomars Mahboubi, Birthe Dinesen. Predictors of Walking Activity in Patients With Systolic Heart Failure Equipped With a Step Counter: Randomized Controlled Trial. JMIR Biomedical Engineering. 2020; 5 (1):e20776.
Chicago/Turabian StyleJosefine Dam Gade; Helle Spindler; Malene Hollingdal; Jens Refsgaard; Lars Dittmann; Lars Frost; Kiomars Mahboubi; Birthe Dinesen. 2020. "Predictors of Walking Activity in Patients With Systolic Heart Failure Equipped With a Step Counter: Randomized Controlled Trial." JMIR Biomedical Engineering 5, no. 1: e20776.
Background Telerehabilitation programs are designed with the aim of improving the quality of services as well as overcoming existing limitations in terms of resource management and accessibility of services. This review will collect recent studies investigating telerehabilitation programs for patients with knee osteoarthritis while focusing on the technologies and services provided in the programs. Objective The main objective of this review is to identify and discuss the modes of service delivery and technologies in telerehabilitation programs for patients with knee osteoarthritis. The gaps, strengths, and weaknesses of programs will be discussed individually. Methods Studies published in English since 2000 were retrieved from the EMBASE, Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, Physiotherapy Evidence Database (PEDro), and PsycINFO databases. The search words “telerehabilitation,” “telehealth,” “telemedicine,” “teletherapy,” and “ehealth” were combined with “knee” and “rehabilitation” to generate a data set of studies for screening and review. The final group of studies reviewed here includes those that implemented teletreatment for patients for at least 2 weeks of rehabilitation. Results In total, 1198 studies were screened, and the full text of 154 studies was reviewed. Of these, 38 studies were included, and data were extracted accordingly. Four modes of telerehabilitation service delivery were identified: phone-based, video-based, sensor-based, and expert system–based telerehabilitation. The intervention services provided in the studies included information, training, communication, monitoring, and tracking. Video-based telerehabilitation programs were frequently used. Among the identified services, information and educational material were introduced in only one-quarter of the studies. Conclusions Video-based telerehabilitation programs can be considered the best alternative solution to conventional treatment. This study shows that, in recent years, sensor-based solutions have also become more popular due to rapid developments in sensor technology. Nevertheless, communication and human-generated feedback remain as important as monitoring and intervention services.
Mreza Naeemabadi; Hesam Fazlali; Samira Najafi; Birthe Dinesen; John Hansen. Telerehabilitation for Patients With Knee Osteoarthritis: A Focused Review of Technologies and Teleservices. JMIR Biomedical Engineering 2020, 5, e16991 .
AMA StyleMreza Naeemabadi, Hesam Fazlali, Samira Najafi, Birthe Dinesen, John Hansen. Telerehabilitation for Patients With Knee Osteoarthritis: A Focused Review of Technologies and Teleservices. JMIR Biomedical Engineering. 2020; 5 (1):e16991.
Chicago/Turabian StyleMreza Naeemabadi; Hesam Fazlali; Samira Najafi; Birthe Dinesen; John Hansen. 2020. "Telerehabilitation for Patients With Knee Osteoarthritis: A Focused Review of Technologies and Teleservices." JMIR Biomedical Engineering 5, no. 1: e16991.
BACKGROUND Physical activity has been shown to decrease cardiovascular mortality and morbidity. Walking, a simple physical activity which is an integral part of daily life, is a feasible and safe activity for patients with heart failure (HF). A step counter, measuring daily walking activity, might be a motivational factor for increased activity. OBJECTIVE The aim of this study was to examine the association between walking activity and demographical and clinical data of patients with HF, and whether these associations could be used as predictors of walking activity. METHODS A total of 65 patients with HF from the Future Patient Telerehabilitation (FPT) program were included in this study. The patients monitored their daily activity using a Fitbit step counter for 1 year. This monitoring allowed for continuous and safe data transmission of self-monitored activity data. RESULTS A higher walking activity was associated with younger age, lower New York Heart Association (NYHA) classification, and higher ejection fraction (EF). There was a statistically significant correlation between the number of daily steps and NYHA classification at baseline (P=.01), between the increase in daily steps and EF at baseline (P<.001), and between the increase in daily steps and improvement in EF (P=.005). The patients’ demographic, clinical, and activity data could predict 81% of the variation in daily steps. CONCLUSIONS This study demonstrated an association between demographic, clinical, and activity data for patients with HF that could predict daily steps. A step counter can thus be a useful tool to help patients monitor their own physical activity. CLINICALTRIAL ClinicalTrials.gov NCT03388918; https://clinicaltrials.gov/ct2/show/NCT03388918 INTERNATIONAL REGISTERED REPORT RR2-10.2196/14517
Josefine Dam Gade; Helle Spindler; Malene Hollingdal; Jens Refsgaard; Lars Dittmann; Lars Frost; Kiomars Mahboubi; Birthe Dinesen. Predictors of Walking Activity in Patients With Systolic Heart Failure Equipped With a Step Counter: Randomized Controlled Trial (Preprint). 2020, 1 .
AMA StyleJosefine Dam Gade, Helle Spindler, Malene Hollingdal, Jens Refsgaard, Lars Dittmann, Lars Frost, Kiomars Mahboubi, Birthe Dinesen. Predictors of Walking Activity in Patients With Systolic Heart Failure Equipped With a Step Counter: Randomized Controlled Trial (Preprint). . 2020; ():1.
Chicago/Turabian StyleJosefine Dam Gade; Helle Spindler; Malene Hollingdal; Jens Refsgaard; Lars Dittmann; Lars Frost; Kiomars Mahboubi; Birthe Dinesen. 2020. "Predictors of Walking Activity in Patients With Systolic Heart Failure Equipped With a Step Counter: Randomized Controlled Trial (Preprint)." , no. : 1.
Brain–computer interfaces (BCIs) can be used in neurorehabilitation; however, the literature about transferring the technology to rehabilitation clinics is limited. A key component of a BCI is the headset, for which several options are available. The aim of this study was to test four commercially available headsets’ ability to record and classify movement intentions (movement-related cortical potentials—MRCPs). Twelve healthy participants performed 100 movements, while continuous EEG was recorded from the headsets on two different days to establish the reliability of the measures: classification accuracies of single-trials, number of rejected epochs, and signal-to-noise ratio. MRCPs could be recorded with the headsets covering the motor cortex, and they obtained the best classification accuracies (73%−77%). The reliability was moderate to good for the best headset (a gel-based headset covering the motor cortex). The results demonstrate that, among the evaluated headsets, reliable recordings of MRCPs require channels located close to the motor cortex and potentially a gel-based headset.
Mads Jochumsen; Hendrik Knoche; Troels Wesenberg Kjaer; Birthe Dinesen; Preben Kidmose. EEG Headset Evaluation for Detection of Single-Trial Movement Intention for Brain-Computer Interfaces. Sensors 2020, 20, 2804 .
AMA StyleMads Jochumsen, Hendrik Knoche, Troels Wesenberg Kjaer, Birthe Dinesen, Preben Kidmose. EEG Headset Evaluation for Detection of Single-Trial Movement Intention for Brain-Computer Interfaces. Sensors. 2020; 20 (10):2804.
Chicago/Turabian StyleMads Jochumsen; Hendrik Knoche; Troels Wesenberg Kjaer; Birthe Dinesen; Preben Kidmose. 2020. "EEG Headset Evaluation for Detection of Single-Trial Movement Intention for Brain-Computer Interfaces." Sensors 20, no. 10: 2804.
BACKGROUND Telerehabilitation programs are designed with the aim of improving the quality of services as well as overcoming existing limitations in terms of resource management and accessibility of services. This review will collect recent studies investigating telerehabilitation programs for patients with knee osteoarthritis while focusing on the technologies and services provided in the programs. OBJECTIVE The main objective of this review is to identify and discuss the modes of service delivery and technologies in telerehabilitation programs for patients with knee osteoarthritis. The gaps, strengths, and weaknesses of programs will be discussed individually. METHODS Studies published in English since 2000 were retrieved from the EMBASE, Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, Physiotherapy Evidence Database (PEDro), and PsycINFO databases. The search words “telerehabilitation,” “telehealth,” “telemedicine,” “teletherapy,” and “ehealth” were combined with “knee” and “rehabilitation” to generate a data set of studies for screening and review. The final group of studies reviewed here includes those that implemented teletreatment for patients for at least 2 weeks of rehabilitation. RESULTS In total, 1198 studies were screened, and the full text of 154 studies was reviewed. Of these, 38 studies were included, and data were extracted accordingly. Four modes of telerehabilitation service delivery were identified: phone-based, video-based, sensor-based, and expert system–based telerehabilitation. The intervention services provided in the studies included information, training, communication, monitoring, and tracking. Video-based telerehabilitation programs were frequently used. Among the identified services, information and educational material were introduced in only one-quarter of the studies. CONCLUSIONS Video-based telerehabilitation programs can be considered the best alternative solution to conventional treatment. This study shows that, in recent years, sensor-based solutions have also become more popular due to rapid developments in sensor technology. Nevertheless, communication and human-generated feedback remain as important as monitoring and intervention services.
Mreza Naeemabadi; Hesam Fazlali; Samira Najafi; Birthe Dinesen; John Hansen. Telerehabilitation for Patients With Knee Osteoarthritis: A Focused Review of Technologies and Teleservices (Preprint). 2019, 1 .
AMA StyleMreza Naeemabadi, Hesam Fazlali, Samira Najafi, Birthe Dinesen, John Hansen. Telerehabilitation for Patients With Knee Osteoarthritis: A Focused Review of Technologies and Teleservices (Preprint). . 2019; ():1.
Chicago/Turabian StyleMreza Naeemabadi; Hesam Fazlali; Samira Najafi; Birthe Dinesen; John Hansen. 2019. "Telerehabilitation for Patients With Knee Osteoarthritis: A Focused Review of Technologies and Teleservices (Preprint)." , no. : 1.
Background Cardiovascular disease is the leading cause of mortality worldwide, accounting for 13%-15% of all deaths. Cardiac rehabilitation has poor compliance and adherence. Telerehabilitation has been introduced to increase patients’ participation, access, and adherence with the help of digital technologies. The target group is patients with heart failure. A telerehabilitation program called “Future Patient” has been developed and consists of three phases: (1) titration of medicine (0-3 months), (2) implementation of the telerehabilitation protocols (3 months), and (3) follow-up with rehabilitation in everyday life (6 months). Patients in the Future Patient program measure their blood pressure, pulse, weight, number of steps taken, sleep, and respiration and answer questions online regarding their well-being. All data are transmitted and accessed in the HeartPortal by patients and health care professionals. Objective The aim of this paper is to describe the research design, outcome measures, and data collection techniques in the clinical test of the Future Patient Telerehabilitation Program for patients with heart failure. Methods A randomized controlled study will be performed. The intervention group will follow the Future Patient Telerehabilitation program, and the control group will follow the traditional cardiac rehabilitation program. The primary outcome is quality of life measured by the Kansas City Cardiomyopathy Questionnaire. Secondary outcomes are development of clinical data; illness perception; motivation; anxiety and depression; health and electronic health literacy; qualitative exploration of patients’, spouses’, and health care professionals’ experiences of participating in the telerehabilitation program; and a health economy evaluation of the program. Outcomes were assessed using questionnaires and through the data generated by digital technologies. Results Data collection began in December 2016 and will be completed in October 2019. The study results will be published in peer-reviewed journals and presented at international conferences. Results from the Future Patient Telerehabilitation program are expected to be published by the spring of 2020. Conclusions The expected outcomes are increased quality of life, increased motivation and illness perception, reduced anxiety and depressions, improved electronic health literacy, and health economics benefits. We expect the study to have a clinical impact for future telerehabilitation of patients with heart failure. Trial Registration ClinicalTrials.gov NCT03388918; https://clinicaltrials.gov/ct2/show/NCT03388918 International Registered Report Identifier (IRRID) DERR1-10.2196/14517
Birthe Dinesen; Lars Dittmann; Josefine Dam Gade; Cecilia Klitgaard Jørgensen; Malene Hollingdal; Soeren Leth; Camilla Melholt; Helle Spindler; Jens Refsgaard. “Future Patient” Telerehabilitation for Patients With Heart Failure: Protocol for a Randomized Controlled Trial. JMIR Research Protocols 2019, 8, e14517 .
AMA StyleBirthe Dinesen, Lars Dittmann, Josefine Dam Gade, Cecilia Klitgaard Jørgensen, Malene Hollingdal, Soeren Leth, Camilla Melholt, Helle Spindler, Jens Refsgaard. “Future Patient” Telerehabilitation for Patients With Heart Failure: Protocol for a Randomized Controlled Trial. JMIR Research Protocols. 2019; 8 (9):e14517.
Chicago/Turabian StyleBirthe Dinesen; Lars Dittmann; Josefine Dam Gade; Cecilia Klitgaard Jørgensen; Malene Hollingdal; Soeren Leth; Camilla Melholt; Helle Spindler; Jens Refsgaard. 2019. "“Future Patient” Telerehabilitation for Patients With Heart Failure: Protocol for a Randomized Controlled Trial." JMIR Research Protocols 8, no. 9: e14517.
Purpose: Seasons and weather conditions might influence participation in physical activity and contribute to differences between countries. This study aimed at investigating whether there were differences in physical activity levels between Norwegian, Danish and Australian people with chronic obstructive pulmonary disease (COPD), and establishing if any variations in physical activity were attributable to seasons. Patients and methods: A cross-sectional study where study subjects were people with COPD who participated in two separate clinical trials: the iTrain study (Norway, Denmark, and Australia) and the HomeBase study (Australia). Physical activity was objectively assessed with an activity monitor; variables were total energy expenditure, number of daily steps, awake sedentary time, light, and moderate-to-vigorous intensity physical activity. Differences in physical activity between countries and seasons were compared, with adjustment for disease severity. Results: In total, 168 participants were included from Norway (N=38), Denmark (N=36) and Australia (N=94). After controlling for disease severity, time spent in awake sedentary time was greater in Danish participants compared to the other countries (median 784 minutes/day [660–952] vs 775 minutes/day [626–877] for Norwegians vs 703 minutes/day [613–802] for Australians, P=0.013), whilst time spent in moderate to vigorous physical activity was lower (median 21 minutes/day [4–73] vs 30 minutes/day [7–93] for Norwegians vs 48 minutes/day [19–98] for Australians, P=0.024). Participants walked more during summer (median 3502 [1253–5407] steps/day) than in spring (median 2698 [1613–5207] steps/day), winter (median 2373 [1145–4206] steps/day) and autumn (median 1603 [738–4040] steps/day), regardless of geography. The median difference between summer and other seasons exceeded the minimal clinically important difference of 600 steps/day. However, the differences were not statistically significant (P=0.101). Conclusion: After controlling for disease severity, Danish participants spent more time in an awake sedentary state and less time in moderate to vigorous physical activity than their counterparts in Norway and Australia. People with COPD increased their physical activity in summer compared to other seasons. Weather conditions and seasonal variations may influence outcomes in clinical trials and health registries measuring physical activity over time, irrespective of the interventions delivered, and should be taken into account when interpreting results.
Hanne Hoaas; Paolo Zanaboni; Audhild Hjalmarsen; Bente Morseth; Birthe Dinesen; Angela T Burge; Narelle S Cox; Anne E Holland. Seasonal variations in objectively assessed physical activity among people with COPD in two Nordic countries and Australia: a cross-sectional study. International Journal of Chronic Obstructive Pulmonary Disease 2019, ume 14, 1219 -1228.
AMA StyleHanne Hoaas, Paolo Zanaboni, Audhild Hjalmarsen, Bente Morseth, Birthe Dinesen, Angela T Burge, Narelle S Cox, Anne E Holland. Seasonal variations in objectively assessed physical activity among people with COPD in two Nordic countries and Australia: a cross-sectional study. International Journal of Chronic Obstructive Pulmonary Disease. 2019; ume 14 ():1219-1228.
Chicago/Turabian StyleHanne Hoaas; Paolo Zanaboni; Audhild Hjalmarsen; Bente Morseth; Birthe Dinesen; Angela T Burge; Narelle S Cox; Anne E Holland. 2019. "Seasonal variations in objectively assessed physical activity among people with COPD in two Nordic countries and Australia: a cross-sectional study." International Journal of Chronic Obstructive Pulmonary Disease ume 14, no. : 1219-1228.
Implementation of cardiac rehabilitation has not been optimal, with patient participation rates below 50%. Factors that contribute to cardiac patients' lack of participation in rehabilitation programs are patient motivation, logistical difficulties in getting to the rehabilitation facilities, lack of psychosocial elements, and individualization of activities in the rehabilitation programs. Telerehabilitation has been proposed as a new way to address the challenge of engaging and motivating cardiac patients and their partners to participate in rehabilitation. The aim of this study was to explore the experiences of cardiac patients and their partners of participating in the Teledialog Telerehabilitation Program (TTP). The Teledialog program consisted of a digital rehabilitation plan, transmission of health data from patient's home to hospital and health care center, and an interactive Web portal with information and training videos. This case study used a theoretical approach combining the "community of practice" approach and self-determination theory. A triangulation of data collection techniques was used, including documents, participant observation (72 hours), and qualitative interviews with cardiac patients and their partners enrolled in the telerehabilitation group. A total of 14 cardiac patients, 12 patient spouses/partners, and 1 son participated in the study. The participants were interviewed at enrollment in the telerehabilitation program and after 12 weeks of participation in the program. Interview data were analyzed using NVivo 11.0. Patients and their partners found the Web portal ActiveHeart.dk and the electronic rehabilitation (e-rehabilitation) plan to be helpful tools for health education, coordinating rehabilitation goals, creating an overview of the data, and ensuring continuity in the rehabilitation process. The patients felt that the TTP treated them as individuals, gave them a sense of autonomy, and provided enhanced relatedness to health care professionals and partners and a sense of competence as active participants in their own rehabilitation process. Some patients missed being part of a community of practice with other cardiac patients and did not use the Web forum. Patients' partners found that the telerehabilitation program gave them a sense of security and helped them balance their involvement as a partner to the patient and not push the patient too hard. Cardiac patients and their partners found telerehabilitation technologies a useful digital toolbox in the rehabilitation process. Telerehabilitation motivated the patients to integrate rehabilitation activities into their work schedule and everyday life and made them feel like unique individuals. Participating in the Teledialog Telerehabilitation Program might not be a suitable strategy for all cardiac patients. Being a patient's partner in the telerehabilitation program was associated with a heightened sense of security, navigation between active involvement in the rehabilitation process, being an equal partner, and not pushing the patient too hard.
Birthe Dinesen; Gitte Nielsen; Jan Jesper Andreasen; Helle Spindler. Integration of Rehabilitation Activities Into Everyday Life Through Telerehabilitation: Qualitative Study of Cardiac Patients and Their Partners. Journal of Medical Internet Research 2019, 21, e13281 .
AMA StyleBirthe Dinesen, Gitte Nielsen, Jan Jesper Andreasen, Helle Spindler. Integration of Rehabilitation Activities Into Everyday Life Through Telerehabilitation: Qualitative Study of Cardiac Patients and Their Partners. Journal of Medical Internet Research. 2019; 21 (4):e13281.
Chicago/Turabian StyleBirthe Dinesen; Gitte Nielsen; Jan Jesper Andreasen; Helle Spindler. 2019. "Integration of Rehabilitation Activities Into Everyday Life Through Telerehabilitation: Qualitative Study of Cardiac Patients and Their Partners." Journal of Medical Internet Research 21, no. 4: e13281.
Telerehabilitation (TR) has gained attention as a promising rehabilitation format. Our study examined how patients responded to TR and whether it provided adequate support for their lifestyle changes and self-care efforts when compared to conventional rehabilitation (CR). Cardiac patients (n = 136) were randomly assigned to a TR or CR group. The TR group was provided with relevant health care technology for a period of three months, and both groups filled in questionnaires on their motivation for lifestyle changes and self-care psychological distress, and quality of life at 0, 3, 6, and 12 months. Patients in both groups were found to be equally motivated for lifestyle changes and self-care (p < 0.05) and they experienced similar levels of psychological distress and quality of life. TR is comparable to conventional rehabilitation in motivating patients, preventing psychological distress and improving quality of life. Although we observed an initial increase in autonomous motivation in the telerehabilitation group, this positive difference in motivation does not last over time. As such, neither rehabilitation format seems able to ensure long-term motivation. Therefore, TR may serve as a viable replacement for conventional rehabilitation when considered relevant. Further research is needed to enhance long-term motivation, and maybe telerehabilitation can help to achieve this.
Helle Spindler; Kasper Leerskov; Katrine Joensson; Gitte Nielsen; Jan Jesper Andreasen; Birthe Dinesen. Conventional Rehabilitation Therapy Versus Telerehabilitation in Cardiac Patients: A Comparison of Motivation, Psychological Distress, and Quality of Life. International Journal of Environmental Research and Public Health 2019, 16, 512 .
AMA StyleHelle Spindler, Kasper Leerskov, Katrine Joensson, Gitte Nielsen, Jan Jesper Andreasen, Birthe Dinesen. Conventional Rehabilitation Therapy Versus Telerehabilitation in Cardiac Patients: A Comparison of Motivation, Psychological Distress, and Quality of Life. International Journal of Environmental Research and Public Health. 2019; 16 (3):512.
Chicago/Turabian StyleHelle Spindler; Kasper Leerskov; Katrine Joensson; Gitte Nielsen; Jan Jesper Andreasen; Birthe Dinesen. 2019. "Conventional Rehabilitation Therapy Versus Telerehabilitation in Cardiac Patients: A Comparison of Motivation, Psychological Distress, and Quality of Life." International Journal of Environmental Research and Public Health 16, no. 3: 512.
BACKGROUND Implementation of cardiac rehabilitation has not been optimal, with patient participation rates below 50%. Factors that contribute to cardiac patients’ lack of participation in rehabilitation programs are patient motivation, logistical difficulties in getting to the rehabilitation facilities, lack of psychosocial elements, and individualization of activities in the rehabilitation programs. Telerehabilitation has been proposed as a new way to address the challenge of engaging and motivating cardiac patients and their partners to participate in rehabilitation. OBJECTIVE The aim of this study was to explore the experiences of cardiac patients and their partners of participating in the Teledialog Telerehabilitation Program (TTP). The Teledialog program consisted of a digital rehabilitation plan, transmission of health data from patient’s home to hospital and health care center, and an interactive Web portal with information and training videos. METHODS This case study used a theoretical approach combining the “community of practice” approach and self-determination theory. A triangulation of data collection techniques was used, including documents, participant observation (72 hours), and qualitative interviews with cardiac patients and their partners enrolled in the telerehabilitation group. A total of 14 cardiac patients, 12 patient spouses/partners, and 1 son participated in the study. The participants were interviewed at enrollment in the telerehabilitation program and after 12 weeks of participation in the program. Interview data were analyzed using NVivo 11.0. RESULTS Patients and their partners found the Web portal ActiveHeart.dk and the electronic rehabilitation (e-rehabilitation) plan to be helpful tools for health education, coordinating rehabilitation goals, creating an overview of the data, and ensuring continuity in the rehabilitation process. The patients felt that the TTP treated them as individuals, gave them a sense of autonomy, and provided enhanced relatedness to health care professionals and partners and a sense of competence as active participants in their own rehabilitation process. Some patients missed being part of a community of practice with other cardiac patients and did not use the Web forum. Patients’ partners found that the telerehabilitation program gave them a sense of security and helped them balance their involvement as a partner to the patient and not push the patient too hard. CONCLUSIONS Cardiac patients and their partners found telerehabilitation technologies a useful digital toolbox in the rehabilitation process. Telerehabilitation motivated the patients to integrate rehabilitation activities into their work schedule and everyday life and made them feel like unique individuals. Participating in the Teledialog Telerehabilitation Program might not be a suitable strategy for all cardiac patients. Being a patient’s partner in the telerehabilitation program was associated with a heightened...
Birthe Dinesen; Gitte Nielsen; Jan Jesper Andreasen; Helle Spindler. Integration of Rehabilitation Activities Into Everyday Life Through Telerehabilitation: Qualitative Study of Cardiac Patients and Their Partners (Preprint). 2019, 1 .
AMA StyleBirthe Dinesen, Gitte Nielsen, Jan Jesper Andreasen, Helle Spindler. Integration of Rehabilitation Activities Into Everyday Life Through Telerehabilitation: Qualitative Study of Cardiac Patients and Their Partners (Preprint). . 2019; ():1.
Chicago/Turabian StyleBirthe Dinesen; Gitte Nielsen; Jan Jesper Andreasen; Helle Spindler. 2019. "Integration of Rehabilitation Activities Into Everyday Life Through Telerehabilitation: Qualitative Study of Cardiac Patients and Their Partners (Preprint)." , no. : 1.
Cardiovascular disease is a leading cause of death globally causing 31% of all deaths worldwide. The Danish health care system is characterized by fragmented delivery of services and rehabilitation activities. The Teledialog Telerehabilitation Program for cardiac patients was developed and tested to rectify fragmentation and improve the quality of care. The Teledialog program was based on the assumption that a common communication platform shared by health care professionals, patients, and relatives could reduce or eliminate the fragmentation in the rehabilitation process and improve cooperation between the health professionals. This study aimed to assess the interorganizational cooperation between health care professionals across sectors (hospitals, municipal health care centers) in a cardiac telerehabilitation program. Theories of networks between organizations, the sociology of professions, and the “community of practice” approach were used in a case study of a cardiac telerehabilitation program. A triangulation of data collection techniques were used including documents, participant observation (n=76 hours), and qualitative interviews with healthcare professionals (n=37). Data were analyzed using NVivo 11.0. The case study of cooperation in an interorganizational context of cardiac telerehabilitation program is characterized by the following key themes and patterns: (1) integrated workflows via a shared digital rehabilitation plan that help integrate workflow between health care professions and organizations, (2) joint clinical practice showed as a community of practice in telerehabilitation developed across professions and organizations, and (3) unifying the organizations as cooperation has advanced via a joint telerehabilitation program across municipalities and hospitals. The Teledialog Telerehabilitation Program was a new innovative cardiac program tested on a large scale across hospitals, health care centers, and municipalities. Assessments showed that the Teledialog program and its associated technologies helped improve interorganizational cooperation and reduce fragmentation. The program helped integrate the organizations and led to the creation of a community of practice. Further research is needed to explore long-term effects of implementation of telerehabilitation technologies and programs. ClinicalTrials.gov NCT01752192; http://clinicaltrials.gov/ct2/show/NCT01752192 (Archived by WebCite at http://www.webcitation.org/6yR3tdEpb)
Birthe Dinesen; Helle Spindler; Dorthe Danbjørg; Robyn Gallagher; Annett Salzwedel. The Use of Telerehabilitation Technologies for Cardiac Patients to Improve Rehabilitation Activities and Unify Organizations: Qualitative Study. JMIR Rehabilitation and Assistive Technologies 2018, 5, e10758 .
AMA StyleBirthe Dinesen, Helle Spindler, Dorthe Danbjørg, Robyn Gallagher, Annett Salzwedel. The Use of Telerehabilitation Technologies for Cardiac Patients to Improve Rehabilitation Activities and Unify Organizations: Qualitative Study. JMIR Rehabilitation and Assistive Technologies. 2018; 5 (2):e10758.
Chicago/Turabian StyleBirthe Dinesen; Helle Spindler; Dorthe Danbjørg; Robyn Gallagher; Annett Salzwedel. 2018. "The Use of Telerehabilitation Technologies for Cardiac Patients to Improve Rehabilitation Activities and Unify Organizations: Qualitative Study." JMIR Rehabilitation and Assistive Technologies 5, no. 2: e10758.
BACKGROUND Cardiovascular disease is a leading cause of death globally causing 31% of all deaths worldwide. The Danish health care system is characterized by fragmented delivery of services and rehabilitation activities. The Teledialog Telerehabilitation Program for cardiac patients was developed and tested to rectify fragmentation and improve the quality of care. The Teledialog program was based on the assumption that a common communication platform shared by health care professionals, patients, and relatives could reduce or eliminate the fragmentation in the rehabilitation process and improve cooperation between the health professionals. OBJECTIVE This study aimed to assess the interorganizational cooperation between health care professionals across sectors (hospitals, municipal health care centers) in a cardiac telerehabilitation program. METHODS Theories of networks between organizations, the sociology of professions, and the “community of practice” approach were used in a case study of a cardiac telerehabilitation program. A triangulation of data collection techniques were used including documents, participant observation (n=76 hours), and qualitative interviews with healthcare professionals (n=37). Data were analyzed using NVivo 11.0. RESULTS The case study of cooperation in an interorganizational context of cardiac telerehabilitation program is characterized by the following key themes and patterns: (1) integrated workflows via a shared digital rehabilitation plan that help integrate workflow between health care professions and organizations, (2) joint clinical practice showed as a community of practice in telerehabilitation developed across professions and organizations, and (3) unifying the organizations as cooperation has advanced via a joint telerehabilitation program across municipalities and hospitals. CONCLUSIONS The Teledialog Telerehabilitation Program was a new innovative cardiac program tested on a large scale across hospitals, health care centers, and municipalities. Assessments showed that the Teledialog program and its associated technologies helped improve interorganizational cooperation and reduce fragmentation. The program helped integrate the organizations and led to the creation of a community of practice. Further research is needed to explore long-term effects of implementation of telerehabilitation technologies and programs. CLINICALTRIAL ClinicalTrials.gov NCT01752192; http://clinicaltrials.gov/ct2/show/NCT01752192 (Archived by WebCite at http://www.webcitation.org/6yR3tdEpb)
Birthe Dinesen; Helle Spindler. The Use of Telerehabilitation Technologies for Cardiac Patients to Improve Rehabilitation Activities and Unify Organizations: Qualitative Study (Preprint). 2018, 1 .
AMA StyleBirthe Dinesen, Helle Spindler. The Use of Telerehabilitation Technologies for Cardiac Patients to Improve Rehabilitation Activities and Unify Organizations: Qualitative Study (Preprint). . 2018; ():1.
Chicago/Turabian StyleBirthe Dinesen; Helle Spindler. 2018. "The Use of Telerehabilitation Technologies for Cardiac Patients to Improve Rehabilitation Activities and Unify Organizations: Qualitative Study (Preprint)." , no. : 1.
Objective: To determine how cardiac patients use the Activeheart.dk digital toolbox Methods: Mixed-methods study. A total of n = 33 cardiac surgical patients were enrolled in a study, which encouraged use of the Activeheart portal for 4 weeks after discharge. Patients were surveyed with respect to their demographic characteristics, e-health literacy skills, use of the Internet and use of the portal. In addition to the questionnaire survey, qualitative interviews were conducted with six randomly selected patients in order to study users’ experiences with and use of the portal. Results: Quantitative results showed no relation between cardiac patients’ prior e-health literacy skills and their use of the portal. Approximately 25 out of 31 patients stated that they had the skills to seek, locate and use health information on the Internet. Among the 17 patients who completed the first and second questionnaires, nine rarely used Activeheart.dk, four used it several times per month, and four several times per week. In 10 out of 16 replies, Activeheart.dk was rated as relevant or very relevant. Themes from the qualitative interviews revealed that the effects of medication and emotional, physical and cognitive changes had a higher impact on the use of the portal than prior e-health literacy skills. Conclusion: While participants’ e-health literacy skills ratings were high, and while participants stated that the content of the portal was relevant, their actual use of the portal remained limited. No relationship was found between participants’ e-health literacy skills and their use of the portal. Factors such as patient motivation, resources and timing of the intervention’s introduction seemed to be of greater importance.
Delvin Khan; Annette Fjerbæk; Jan J Andreasen; Charlotte B Thorup; Birthe Dinesen. Cardiac surgery patients’ e-health literacy and their use of a digital portal. Health Education Journal 2018, 77, 482 -494.
AMA StyleDelvin Khan, Annette Fjerbæk, Jan J Andreasen, Charlotte B Thorup, Birthe Dinesen. Cardiac surgery patients’ e-health literacy and their use of a digital portal. Health Education Journal. 2018; 77 (4):482-494.
Chicago/Turabian StyleDelvin Khan; Annette Fjerbæk; Jan J Andreasen; Charlotte B Thorup; Birthe Dinesen. 2018. "Cardiac surgery patients’ e-health literacy and their use of a digital portal." Health Education Journal 77, no. 4: 482-494.