A six-week physical therapy exercise program delivered via home-based telerehabilitation is comparable to in-person programs for patients with burn injuries: A randomized,controlled, non-inferiority clinical pilot trial |
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| Affiliation: | 1. Physiotherapy Department, Royal Brisbane and Women’s Hospital, Brisbane, QLD 4029, Australia;2. Professor Stuart Pegg Adult Burn Centre, Royal Brisbane and Women’s Hospital, Herston, Brisbane, QLD 4029, Australia;3. Physiotherapy Department, Griffith University, Brisbane, QLD 4222, Australia;1. Burn Injury Research Unit, School of Biomedical sciences, University of Western Australia, Perth, WA, Australia;2. Burns Service WA, WA Department of Health, Perth, WA, Australia;3. Fiona Wood Foundation, Perth, WA, Australia;4. Centre for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Perth, WA 6150, Australia;5. Australian National Phenome Centre, Health Futures Institute, Murdoch University, Perth, WA 6150, Australia;6. Perron Institute for Neurological and Translational Science, Nedlands, WA 6009, Australia;7. Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, Sir Alexander Fleming Building, South Kensington, London SW7 2AZ, UK;8. Institute of Global Health Innovation, Imperial College London, London SW7 2AZ, UK;1. Department of Anesthesiology, the First Affiliated Hospital of Sun Yat-sen University, China;2. Department of Anesthesiology, the Dongguan People''s Hospital, China;3. Department of Anesthesiology, Zhongshan People''s Hospital, China;1. Department of Plastic Surgery and Hand Surgery, Burn Center, University Hospital Zürich, Switzerland;2. Department of Plastic Surgery and Hand Surgery, Kantonsspital Aarau, Switzerland;1. Department of Plastic, Reconstructive and Aesthetic Surgery, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey;2. Department of Plastic, Reconstructive and Aesthetic Surgery, Sirnak State Hospital, Sirnak, Turkey;3. Department of Clinical Pathology, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey;4. Department of Anesthesiology and Reanimation, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey;1. Multidisciplinary Metabolic Research Unit (M2RUN), MOVANT Research Group, Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium;2. Burn unit, ZNA Stuivenberg, Lange Beeldekensstraat 267, 2060 Antwerp, Belgium;3. Burn unit, Military Hospital Queen Astrid, Rue Bruyn 1, 1120 Brussels, Belgium;4. OSCARE, Organization for burns, scar after-care and research, Van Roiestraat 18, 2170 Antwerp, Belgium;5. Multidisciplinary Edema Clinic, Antwerp University Hospital, Drie Eikenstraat 655, 2650 Edegem, Belgium |
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| Abstract: | BackgroundExercise programmes are essential for burn rehabilitation, however patients often have barriers accessing these services. Home-based telerehabilitation (HBT) may be an alternative. This study aimed to determine if exercise programs delivered via HBT were as effective as in-person (IP) programs with respect to clinical outcomes and participant and therapist satisfaction.MethodsA single center, randomized, controlled, non-inferiority pilot trial with blinded assessment was undertaken. Forty-five adults with ≤ 25% total body surface area (TBSA) burns were randomized to receive a 6-week exercise program delivered either by HBT or IP. The primary outcome was burn-specific quality of life (Burn Specific Health Scale – Brief). Secondary outcomes included health-related quality of life, burn scar-specific outcomes, exercise self-efficacy, pain severity, muscle strength and range of motion (ROM). Participant and therapist satisfaction, technical disruptions and adverse events were also recorded.ResultsWe found no significant within- or between-group differences for any outcome measures except ROM. Achievement of full ROM was significantly different between groups at Week 12 (IP=100% vs HBT=70%, p = 0.005). Non-inferiority was inconclusive. Participant satisfaction was high (median ≥ 9.8/10), with no significant between-group differences. Therapist satisfaction was high (median ≥ 8.9/10), major technical disruptions low (8%) and no adverse events reported.ConclusionHBT is a safe, effective option to deliver exercise programs for patients with burn injuries ≤ 25% TBSA with comparable clinical outcomes to in-person programmes. Ongoing research is required to further analyze ROM and investigate the effectiveness of HBT for patients with larger burns. |
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| Keywords: | Telerehabilitation Telehealth Physical therapy Exercise Burns |
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