Ms Anita Plaza1, Ms Jennifer Paratz1, Ms Michelle Cottrell1
1Royal Brisbane And Women’s Hospital, Everton Hills, Australia
Physiotherapy is essential for rehabilitation post burn injury but limited resources in regional areas means access is often reduced. Home-based telerehabilitation (HBT) is an alternative method of delivering physiotherapy programs and to date there are no studies investigating the effectiveness of HBT exercise programs in an adult burn population. Therefore, the aim of this study was to determine whether physiotherapy delivered via HBT is as effective as standard outpatient programs with respect to clinical outcomes, cost effectiveness and satisfaction.
Methods: A single centre, prospective randomised controlled trial with blinded outcome assessment was used to compare HBT vs Standard Care (SC). Adults aged >18 years who were admitted to the RBWH with < 25%TBSA and had access to an internet-enabled device with web camera were included in this study. A 6-week physiotherapy program, either via standard outpatient appointments or using the eHAB® telerehabilitation system was conducted. Outcome measures were recorded at baseline, 6 and 12 weeks. Outcome measures included Burn Specific Health Scale-Brief (BSHS-B), Australian Quality of Life (AQoL), Brisbane Burn Scar Impact Profile (BBSIP), Numeric Pain Scale, Self-efficacy for Exercise, Muscle Strength, ROM, Cost diary, Patient and Therapist satisfaction surveys.
Results: Recruitment is ongoing and is currently at 9 patients (HBT=5, SC=4) with a mean age of 43.8 years (range 21-58) and mean %TBSA of 5.8% (range 1-21%). Baseline measures show a mean BSHS-B score of 142.2 (HBT) and 130 (SC), a mean pain score of 1.6 (HBT) and 2.8 (SC) and a mean grip strength of 25.8kg (HBT) and 36.6kg (SC). Patient satisfaction showed a mean score of 7.85 in the SC group and 10 in the HBT group. Therapist telerehabilitation satisfaction scores showed a mean of 7.7 for effectiveness with scar visualisation and a mean overall satisfaction rating of 8.7. Further results on patient outcome measures will also be presented.
Conclusion: Patient and therapist satisfaction for the provision of physiotherapy via telerehabilitation looks promising but further data collection is required. If telerehabilitation services are shown to be comparable to standard care, telerehabilitation can then be adopted as an alternative service delivery model for patients to access physiotherapy services.
Anita Plaza is a Consultant physiotherapist in Professor Stuart Pegg Adult Burn Centre at the Royal Brisbane and Women’s Hospital. She has over 20 years of experience in providing physiotherapy services to adults and children with burn injuries and has a keen interest in exercise and outcomes research.