Export file:

Format

  • RIS(for EndNote,Reference Manager,ProCite)
  • BibTex
  • Text

Content

  • Citation Only
  • Citation and Abstract

The ‘wicked problem’ of telerehabilitation: Considerations for planning the way forward

UBC Pulmonary Rehabilitation Research Laboratory, Department of Physical Therapy/Centre for Heart Lung Innovation, University of British Columbia, Vancouver, BC, Canada

Special Issues: Telerehabilitation for Adults and Older Adults

Telerehabilitation offers great promise to improved access to rehabilitation care. The rising use of technology, the increased expansion of data networks worldwide, and the growing confidence and interest of the general population to incorporate technology into their day-to-day lives via the Internet, smartphones and wearables provide fertile ground for many rehabilitation interventions. Despite this opportunity, telerehabilitation is not integrated into existing health care systems today. Most research is focused on the efficacy of the intervention without addressing the complexity of introducing a system of care that is starkly different from the current health care system in most countries. As such, implementation of telerehabilitation may be considered a ‘wicked problem’ in that it is extremely complex and challenging situation that is intricately linked with the social, economic and political contexts. This paper discusses telerehabilitation implementation while considering the intervention, patient, and health care system contexts in which it occurs.
  Figure/Table
  Supplementary
  Article Metrics

Keywords telehealth; telerehabilitation; rehabilitation; health service delivery

Citation: Pat G. Camp. The ‘wicked problem’ of telerehabilitation: Considerations for planning the way forward. AIMS Medical Science, 2018, 5(4): 357-369. doi: 10.3934/medsci.2018.4.357

References

  • 1. American Physical Therapy Association (2009) Position Statement: Telehealth BOD P03-06-10-20. Available from: https://www.apta.org/uploadedFiles/APTAorg/About_Us/Policies/BOD/Practice/Telehealth.pdf.
  • 2. Bernocchi P, Vitacca M, La Rovere MT, et al. (2018) Home-based telerehabilitation in older patients with chronic obstructive pulmonary disease and heart failure: a randomised controlled trial. Age Ageing 47: 82–88.    
  • 3. Frederix I, Hansen D, Coninx K, et al. (2015) Medium-Term Effectiveness of a Comprehensive Internet-Based and Patient-Specific Telerehabilitation Program With Text Messaging Support for Cardiac Patients: Randomized Controlled Trial. J Med Internet Res 17: e185.    
  • 4. Chen J, Jin W, Zhang XX, et al. (2015) Telerehabilitation Approaches for Stroke Patients: Systematic Review and Meta-analysis of Randomized Controlled Trials. J Stroke Cerebrovasc Dis 24: 2660–2668.    
  • 5. Srikesavan C, Bryer C, Ali U, et al. (2018) Web-based rehabilitation interventions for people with rheumatoid arthritis: A systematic review. J Telemed Telecare: 1357633X18768400.
  • 6. Miller S, Mandrusiak A, Adsett J (2018) Getting to the Heart of the Matter: What Is the Landscape of Exercise Rehabilitation for People with Heart Failure in Australia? Heart Lung Circ 27: 1350–1356.    
  • 7. Cox NS, Oliveira CC, Lahham A, et al. (2017) Pulmonary rehabilitation referral and participation are commonly influenced by environment, knowledge, and beliefs about consequences: a systematic review using the Theoretical Domains Framework. J Physiother 63: 84–93.    
  • 8. Rouleau CR, King-Shier KM, Tomfohr-Madsen LM, et al. (2018) A qualitative study exploring factors that influence enrollment in outpatient cardiac rehabilitation. Disabil Rehabil 40: 469–478.    
  • 9. Rittel HWJ, Webber MM (1973) Dilemmas in a general theory of planning. Policy Sciences 4: 155–169.    
  • 10. Conklin J (2005) Dialogue Mapping: Building Shared Understanding of Wicked Problems. John Wiley & Sons, Inc., 266.
  • 11. Christensen CM, Raynor M, McDonald R (2015) What is disruptive innovation? Harvard Business Review 93: 44–53.
  • 12. Kairy D, Tousignant M, Leclerc N, et al. (2013) The patient's perspective of in-home telerehabilitation physiotherapy services following total knee arthroplasty. Int J Environ Res Public Health 10: 3998–4011.    
  • 13. Agostini M, Moja L, Banzi R, et al. (2015) Telerehabilitation and recovery of motor function: a systematic review and meta-analysis. J Telemed Telecare 21: 202–213.    
  • 14. Chan C, Yamabayashi C, Syed N, et al. (2016) Exercise Telemonitoring and Telerehabilitation Compared with Traditional Cardiac and Pulmonary Rehabilitation: A Systematic Review and Meta-Analysis. Physiother Can 68: 242–251.    
  • 15. Jiang S, Xiang J, Gao X, et al. (2018) The comparison of telerehabilitation and face-to-face rehabilitation after total knee arthroplasty: A systematic review and meta-analysis. J Telemed Telecare 24: 257–262.    
  • 16. Chaplin E, Hewitt S, Apps L, et al. (2017) Interactive web-based pulmonary rehabilitation programme: a randomised controlled feasibility trial. BMJ Open 7: e013682.    
  • 17. Frederix I, Vanhees L, Dendale P, et al. (2015) A review of telerehabilitation for cardiac patients. J Telemed Telecare 21: 45–53.    
  • 18. Sarfo FS, Ulasavets U, Opare-Sem OK, et al. (2018) Tele-Rehabilitation after Stroke: An Updated Systematic Review of the Literature. J Stroke Cerebrovasc Dis 27: 2306–2318.    
  • 19. World Health Organization, World Bank (2011) World Report on Disability. Malta: World Health Organization. Available from: http://www.who.int/disabilities/world_report/2011/report.pdf.
  • 20. Duggan M, Smith A (2014) Social Media Update 2013. Pew Research Center. Available from: http://pewinternet.org/Reports/2013/Social-Media-Update.aspx.
  • 21. Anderson M, Perrin A (2017) Tech Adoption Climbs Among Older Adults. Pew Research Center. Available from: http://www.pewinternet.org/2017/05/17/technology-use-among-seniors/.
  • 22. Transcend Insights (2017) Patients Regard Open Access to Their Medical Records as Critical to Receiving High Quality Healthcare. Transcend Insights. Available from: https://transcend-insights-1772-1772.docs.contently.com/v/survey-report-patient-expectations-of-medical-information-sharing-personalized-healthcare?
  • 23. Makovsky Health (2015) Pulse of Online Health Survey. Makovsky. Available from: https://www.makovsky.com/news/fifth-annual-pulse-of-online-health-survey-2/.
  • 24. Edgar MC, Monsees S, Rhebergen J, et al. (2017) Telerehabilitation in Stroke Recovery: A Survey on Access and Willingness to Use Low-Cost Consumer Technologies. Telemed J E Health 23: 421–429.    
  • 25. Moffet H, Tousignant M, Nadeau S, et al. (2015) In-Home Telerehabilitation Compared with Face-to-Face Rehabilitation After Total Knee Arthroplasty: A Noninferiority Randomized Controlled Trial. J Bone Joint Surg Am 97: 1129–1141.    
  • 26. Joober R, Schmitz N, Annable L, et al. (2012) Publication bias: what are the challenges and can they be overcome? J Psychiatry Neurosci 37: 149–152.    
  • 27. Fan VS, Gaziano JM, Lew R, et al. (2012) A comprehensive care management program to prevent chronic obstructive pulmonary disease hospitalizations: a randomized, controlled trial. Ann Intern Med 156: 673–683.    
  • 28. Pocock SJ (2012) Ethical dilemmas and malfunctions in clinical trials research. Ann Intern Med 156: 746–747.    
  • 29. Vandivier RW, Linderman DJ, Koff PB (2012) A comprehensive care management program to prevent chronic obstructive pulmonary disease hospitalizations. Ann Intern Med 157: 530; author reply 530–531.
  • 30. Lupton D (2013) Quantifying the body: monitoring and measuring health in the age of mHealth technologies. Critical Public Health 23: 393–403.    
  • 31. Lupton D (2016) The quantified self: a sociology of self-traking. Malden, MA: Polity Press. 183.
  • 32. Perro J (2018) Mobile Apps: What's a Good Retention Rate? Localytics Blog. Available from: https://info.localytics.com/blog/mobile-apps-whats-a-good-retention-rate.
  • 33. Krebs P, Duncan DT (2015) Health app use among US mobile phone owners: a national survey. JMIR Mhealth Uhealth 3: e101.    
  • 34. Rasche P, Wille M, Brohl C, et al. (2018) Prevalence of health app use among older adults in Germany: national survey. JMIR Mhealth Uhealth 6: e26.    
  • 35. Chaplin E, Hewitt S, Apps L, et al. (2017) Interactive web-based pulmonary rehabilitation programme: a randomized controlled feasibility trial. BMJ Open 7: e013682.    
  • 36. Hwang R, Bruning J, Morris NR, et al. 2017 Home-based telerehabilitation is not inferior to a centre-based program in patients with chronic heart failure: a randomized trial. J Physiotherapy 63: 101–107.
  • 37. Inskip JA, Lauscher HN, Li LC, et al. (2018) Patient and health care professional perspectives on using telehealth to deliver pulmonary rehabilitation. Chron Respir Dis 15: 71–80.    
  • 38. Cottrell MA, Hill AJ, O'Leary SP, et al. (2017) Service provider perceptions of telerehabilitation as an additional service delivery option within an Australian neurosurgical and orthopaedic physiotherapy screening clinic: A qualitative study. Musculoskelet Sci Pract 32: 7–16.    
  • 39. Vassilev I, Rowsell A, Pope C, et al. (2015) Assessing the implementability of telehealth interventions for self-management support: a realist review. Implement Sci 10: 59.    
  • 40. Ross J, Stevenson F, Lau R, et al. (2016) Factors that influence the implementation of e-health: a systematic review of systematic reviews (an update). Implement Sci 11: 146.    
  • 41. Galpin K (2018) Authority of Health Care Providers to Practice Telehealth. Department of Veterans Affairs, eds. Available from: https://www.federalregister.gov/documents/2018/05/11/2018-10114/authority-of-health-care-providers-to-practice-telehealth.
  • 42. (2017) Tele-rehabilitation in Physiotherapy: Guidelines for Physiotherapists. In: Regulators CAoP, eds. Toronto, Ontario. Available from: https://www.alliancept.org/wp-content/uploads/2017/11/Approved-Tele-rehabilitation-Guidelines-for-Physiotherapists-170926-edited-for-public.pdf.

 

Reader Comments

your name: *   your email: *  

© 2018 the Author(s), licensee AIMS Press. This is an open access article distributed under the terms of the Creative Commons Attribution Licese (http://creativecommons.org/licenses/by/4.0)

Download full text in PDF

Export Citation

Copyright © AIMS Press All Rights Reserved