Safety, feasibility and initial efficacy of an app-facilitated telerehabilitation (AFTER) programme for COVID-19 survivors: a pilot randomised study
Objectives Determine the safety, feasibility and initial efficacy of a multicomponent telerehabilitation programme for COVID-19 survivors.Design Pilot randomised feasibility study.Setting In-home telerehabilitation.Participants 44 participants (21 female, mean age 52 years) discharged home following...
Saved in:
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2022-07-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/7/e061285.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832577864309932032 |
|---|---|
| author | Kristine M Erlandson Jacob John Capin Amy Nordon-Craft Sarah E Jolley Jennifer E Stevens-Lapsley Mary Morrow Meghan Connors Kristine Hare Samantha MaWhinney Michelle Rauzi Sheryl Flynn |
| author_facet | Kristine M Erlandson Jacob John Capin Amy Nordon-Craft Sarah E Jolley Jennifer E Stevens-Lapsley Mary Morrow Meghan Connors Kristine Hare Samantha MaWhinney Michelle Rauzi Sheryl Flynn |
| author_sort | Kristine M Erlandson |
| collection | DOAJ |
| description | Objectives Determine the safety, feasibility and initial efficacy of a multicomponent telerehabilitation programme for COVID-19 survivors.Design Pilot randomised feasibility study.Setting In-home telerehabilitation.Participants 44 participants (21 female, mean age 52 years) discharged home following hospitalisation with COVID-19 (with and without intensive care unit (ICU) stay).Interventions Participants were block randomised 2:1 to receive 12 individual biobehaviourally informed, app-facilitated, multicomponent telerehabilitation sessions with a licenced physical therapist (n=29) or to a control group (n=15) consisting of education on exercise and COVID-19 recovery trajectory, physical activity and vitals monitoring, and weekly check-ins with study staff. Interventions were 100% remote and occurred over 12 weeks.Primary and secondary outcome measures The primary outcome was feasibility, including safety and session adherence. Secondary outcomes included preliminary efficacy outcomes including tests of function and balance; patient-reported outcome measures; a cognitive assessment; and average daily step count. The 30 s chair stand test was the main secondary (efficacy) outcome.Results No adverse events (AEs) occurred during testing or in telerehabilitation sessions; 38% (11/29) of the intervention group compared with 60% (9/15) of the control group experienced an AE (p=0.21), most of which were minor, over the course of the 12-week study. 27 of 29 participants (93%; 95% CI 77% to 99%) receiving the intervention attended ≥75% of sessions. Both groups demonstrated clinically meaningful improvement in secondary outcomes with no statistically significant differences between groups.Conclusion Fully remote telerehabilitation was safe, feasible, had high adherence for COVID-19 recovery, and may apply to other medically complex patients including those with barriers to access care. This pilot study was designed to evaluate feasibility; further efficacy evaluation is needed.Trial registration number NCT04663945. |
| format | Article |
| id | doaj-art-edc5ff64e16a408584cf4320cd1d6d39 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-edc5ff64e16a408584cf4320cd1d6d392025-01-30T14:50:08ZengBMJ Publishing GroupBMJ Open2044-60552022-07-0112710.1136/bmjopen-2022-061285Safety, feasibility and initial efficacy of an app-facilitated telerehabilitation (AFTER) programme for COVID-19 survivors: a pilot randomised studyKristine M Erlandson0Jacob John Capin1Amy Nordon-Craft2Sarah E Jolley3Jennifer E Stevens-Lapsley4Mary Morrow5Meghan Connors6Kristine Hare7Samantha MaWhinney8Michelle Rauzi9Sheryl Flynn10Division of Infectious Diseases, University of Colorado – Anschutz Medical Campus, Aurora, Colorado, USADepartment of Physical Therapy, Marquette University, Milwaukee, Wisconsin, USADepartment of Physical Medicine & Rehabilitation, University of Colorado Denver – Anschutz Medical Campus, Aurora, Colorado, USADivision of Pulmonary and Critical Care Medicine, University of Colorado Denver – Anschutz Medical Campus, Aurora, Colorado, USA8 Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USADepartment of Biostatistics and Informatics, University of Colorado Denver – Anschutz Medical Campus, Aurora, Colorado, USADepartment of Physical Medicine & Rehabilitation, University of Colorado Denver – Anschutz Medical Campus, Aurora, Colorado, USADepartment of Physical Medicine & Rehabilitation, University of Colorado Denver – Anschutz Medical Campus, Aurora, Colorado, USADepartment of Biostatistics and Informatics, University of Colorado Denver – Anschutz Medical Campus, Aurora, Colorado, USADepartment of Physical Medicine & Rehabilitation, University of Colorado Denver – Anschutz Medical Campus, Aurora, Colorado, USABlue Marble Health, Altadena, California, USAObjectives Determine the safety, feasibility and initial efficacy of a multicomponent telerehabilitation programme for COVID-19 survivors.Design Pilot randomised feasibility study.Setting In-home telerehabilitation.Participants 44 participants (21 female, mean age 52 years) discharged home following hospitalisation with COVID-19 (with and without intensive care unit (ICU) stay).Interventions Participants were block randomised 2:1 to receive 12 individual biobehaviourally informed, app-facilitated, multicomponent telerehabilitation sessions with a licenced physical therapist (n=29) or to a control group (n=15) consisting of education on exercise and COVID-19 recovery trajectory, physical activity and vitals monitoring, and weekly check-ins with study staff. Interventions were 100% remote and occurred over 12 weeks.Primary and secondary outcome measures The primary outcome was feasibility, including safety and session adherence. Secondary outcomes included preliminary efficacy outcomes including tests of function and balance; patient-reported outcome measures; a cognitive assessment; and average daily step count. The 30 s chair stand test was the main secondary (efficacy) outcome.Results No adverse events (AEs) occurred during testing or in telerehabilitation sessions; 38% (11/29) of the intervention group compared with 60% (9/15) of the control group experienced an AE (p=0.21), most of which were minor, over the course of the 12-week study. 27 of 29 participants (93%; 95% CI 77% to 99%) receiving the intervention attended ≥75% of sessions. Both groups demonstrated clinically meaningful improvement in secondary outcomes with no statistically significant differences between groups.Conclusion Fully remote telerehabilitation was safe, feasible, had high adherence for COVID-19 recovery, and may apply to other medically complex patients including those with barriers to access care. This pilot study was designed to evaluate feasibility; further efficacy evaluation is needed.Trial registration number NCT04663945.https://bmjopen.bmj.com/content/12/7/e061285.full |
| spellingShingle | Kristine M Erlandson Jacob John Capin Amy Nordon-Craft Sarah E Jolley Jennifer E Stevens-Lapsley Mary Morrow Meghan Connors Kristine Hare Samantha MaWhinney Michelle Rauzi Sheryl Flynn Safety, feasibility and initial efficacy of an app-facilitated telerehabilitation (AFTER) programme for COVID-19 survivors: a pilot randomised study BMJ Open |
| title | Safety, feasibility and initial efficacy of an app-facilitated telerehabilitation (AFTER) programme for COVID-19 survivors: a pilot randomised study |
| title_full | Safety, feasibility and initial efficacy of an app-facilitated telerehabilitation (AFTER) programme for COVID-19 survivors: a pilot randomised study |
| title_fullStr | Safety, feasibility and initial efficacy of an app-facilitated telerehabilitation (AFTER) programme for COVID-19 survivors: a pilot randomised study |
| title_full_unstemmed | Safety, feasibility and initial efficacy of an app-facilitated telerehabilitation (AFTER) programme for COVID-19 survivors: a pilot randomised study |
| title_short | Safety, feasibility and initial efficacy of an app-facilitated telerehabilitation (AFTER) programme for COVID-19 survivors: a pilot randomised study |
| title_sort | safety feasibility and initial efficacy of an app facilitated telerehabilitation after programme for covid 19 survivors a pilot randomised study |
| url | https://bmjopen.bmj.com/content/12/7/e061285.full |
| work_keys_str_mv | AT kristinemerlandson safetyfeasibilityandinitialefficacyofanappfacilitatedtelerehabilitationafterprogrammeforcovid19survivorsapilotrandomisedstudy AT jacobjohncapin safetyfeasibilityandinitialefficacyofanappfacilitatedtelerehabilitationafterprogrammeforcovid19survivorsapilotrandomisedstudy AT amynordoncraft safetyfeasibilityandinitialefficacyofanappfacilitatedtelerehabilitationafterprogrammeforcovid19survivorsapilotrandomisedstudy AT sarahejolley safetyfeasibilityandinitialefficacyofanappfacilitatedtelerehabilitationafterprogrammeforcovid19survivorsapilotrandomisedstudy AT jenniferestevenslapsley safetyfeasibilityandinitialefficacyofanappfacilitatedtelerehabilitationafterprogrammeforcovid19survivorsapilotrandomisedstudy AT marymorrow safetyfeasibilityandinitialefficacyofanappfacilitatedtelerehabilitationafterprogrammeforcovid19survivorsapilotrandomisedstudy AT meghanconnors safetyfeasibilityandinitialefficacyofanappfacilitatedtelerehabilitationafterprogrammeforcovid19survivorsapilotrandomisedstudy AT kristinehare safetyfeasibilityandinitialefficacyofanappfacilitatedtelerehabilitationafterprogrammeforcovid19survivorsapilotrandomisedstudy AT samanthamawhinney safetyfeasibilityandinitialefficacyofanappfacilitatedtelerehabilitationafterprogrammeforcovid19survivorsapilotrandomisedstudy AT michellerauzi safetyfeasibilityandinitialefficacyofanappfacilitatedtelerehabilitationafterprogrammeforcovid19survivorsapilotrandomisedstudy AT sherylflynn safetyfeasibilityandinitialefficacyofanappfacilitatedtelerehabilitationafterprogrammeforcovid19survivorsapilotrandomisedstudy |