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EP-106 - Telerehabilitation of Patients with Injuries of the Elbow Joint of the Upper Extremities

Monday, April 30
4:25 PM - 4:40 PM
Location: Education Zone, Booth 2416, Screen 1

Telerehabilitation of patients with injuries of the elbow joint of the upper extremities

Objectives:
The international orthopedic community aims to achieve the best possible outcome for patient care by modifying rehabilitation methods and using telemedicine technology. The theme of this article is to discuss the integration of telemedicine technology in the rehabilitation of patients with injuries of the upper extremities. Currently not sufficiently studied sequential algorithm of movement activity on the injured upper extremity after immobilization, not studied physiological and pathophysiological response during rehabilitation.

Methods:
Consecutive patients were recruited over a 3-year period. A total of 84 subjects with upper extremity elbow joint injuries were enrolled in the study and monitored during 2-weeks period. 48 patients from the control group underwent traditional rehabilitation procedures for a 2-weeks period after completion of immobilization. A total of 36 subjects were enrolled in the telerehabilitation group for a 2-weeks period after completion of immobilization and were trained with a set of exercises for home use. Home remote monitoring for the 36 test subjects included use of a smartphone with gyroscope, G-sensor and magnetometer that was fixed to the injured forearm. Software for smartphone was developed in the I. Horbachevskyy Ternopil Medical University, Ukraine. Software permits the monitoring of exercise time, the frequency of active movements of the injured limb.
Results:
The 1-month rehabilitation period started with the movements in the injured limb. During the telemonitoring, the physician controls the adequacy of execution of each stage of rehabilitation exercises and has the ability to adjust the load in real time depending on the functional state of the limb.
Subjects were also asked if their pain level increased after the first exercise and in the event that it did, they were asked to indicate by how much it increased by picking one of the following three options on the smartphone: 1-4 pain was a bit stronger; 5-7 pain was moderately stronger; and 8-10 pain was much stronger. The algorithm allows increasing the daily load on 1%, if the assessment of pain after exercise was not >7 points on 10-point scale and progressive limb edema was absent. If pain persisted or questions persisted, subjects were invited for a visit to the doctor with correction of the rehabilitation algorithm.
The orthopedic surgeon, during telerehabilitation, took significantly less time to consult patients (2.3 min - 0.4) than the traditional rehabilitation (12.6 min - 2.9). Patient satisfaction was higher for the telerehabilitation (83.1% - 14.2) than for the orthopedic surgeon's traditional rehabilitation (33.1% - 8.9).

Conclusion:
The telerehabilitation system and dosed load algorithm can be used in complex rehabilitation of patients with injuries of the upper extremities. This will improve the quality of life in this group of patients and significantly reduce the cost of the rehabilitation period. These results provide preliminary evidence supporting the telerehabilitation model for orthopedic care. We conclude that telerehabilitation should be considered a key component in the long-term management of patients who have upper extremity injuries.

Learning Objectives:

Andriy Tsvyakh

professor
I. Horbachevskyy Ternopil Medical University

Chief of the orthopedic and traumatology department, I. Horbachevskyy Ternopil Medical University
He conducts comprehensive research on the most problems of orthopedics and traumatology, dominated search, development and clinical introduction of new techniques and means of osteosynthesis and rehabilitation. Since 1994, he started training interns trauma with subsequent certification and training with interns and students of other specialties. Clinical and research interests of Andriy Tsvyakh focused on the problems of qualified emergency and routine care to patients with injuries and diseases of the musculoskeletal system and telerehabilitation of patients with injury of joints.

Presentation(s):

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Andriy Hospodarskyy

Associate professor of surgical department
I. Horbachevskyy Ternopil Medical University

Andriy Hospodarskyy – associate professor of surgery, I. Horbachevskyy Ternopil Medical University. After the first visit to the ATA conference in 1999 (USA, Salt Lake City) began to implement telemedicine projects in Ukraine. In September 1999 the first time in Ukraine, implemented videoconferencing between Kyiv and Ternopil on ISDN technology. Since 2000 introduced distance learning - the first video lectures in Ukraine. He also works as surgeon and proctologist. Author of 78 medical journal articles and co-author of two books on surgery for medical student.

Presentation(s):

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