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SCI: Role of the Registered Dietitian (2007)

Citation:

Galea M, Tumminia J, Garback LM. Telerehabilitation in spinal cord injury persons: a novel approach. Telemedicine and e-Health. 2006;12:160-162.

PubMed ID: 16620171
 
Study Design:
Cohort
Class:
C - Click here for explanation of classification scheme.
Quality Rating:
Negative NEGATIVE: See Quality Criteria Checklist below.
Research Purpose:

Not stated by author.

Inclusion Criteria:
  • Not specifically described except for what an ideal participant would be.
    • frequent hospitalizations or poor compliance to medications, diet, and/or exercise programs.
    • recently discharged from the hospital, at risk for falls, or may have a caregiver requiring additional support.
Exclusion Criteria:

Not described

Description of Study Protocol:

Recruitment

 Not described

Design

  • In the enrollment phase the patient's goals are agreed upon.
  • Depending on the patient's needs a messaging device - the Health Buddy or a vidiophone is selected.
  • With the Health Buddy - patient sends daily information by answering simple questions with a push of the button and if needed, feedback from a nurse is received.
  • Adjustments to care are made by the team as necessary.
  • With videophones (used by persons with pressure ulcers, ventilator dependance, tracheostomies or new injuries) the patient connects on a weekly basis. Issues that requier direct observation can be easily monitored with feedback given instantly.

Blinding used (if applicable)

 Not applicable

Intervention (if applicable)

  • Meals can be observed and provision of guidance on proper protion sizes can be given.
  • Dietary recalls and subsequent follow-up education can be  provided on a personal level
  • Weekly face-to-face interaction can provide psychological support for aging SCI persons.
  • Telerehabilitation is used to evaluate seating, home accessibility/safety concerns and monitoring of a customized home exercise program.
  • In addition the system can provide for nutrition education and counseling for those unable to travel.

Statistical Analysis

 Not described

Data Collection Summary:

Timing of Measurements

  • Baseline information to include patient goals. 
  • With the Health Buddy daily information is sent.
  • With the videophones, information is collected weekly. 

Dependent Variables

  • Original data was not described in the study

Independent Variables

 Control Variables

 

Description of Actual Data Sample:

 

Initial N: 14 patients total: 9 with the Health Buddy system; 5 patients with videophones

Attrition (final N):

Age: Not described

Ethnicity: Not described

Other relevant demographics: Not described

Anthropometrics: Not described

Location:

 James J Peters Veterans Affairs Medical Center, Bronx, NY

Summary of Results:

 

 

None described 

Other Findings

 

Author Conclusion:
  • The program is well accepted by patients and appreciated by caregivers.
  • Office visits have increased.
  • Hospitalizations and length of stay (LOS) have decreased.
  • Some difficulty has been observed with the poor reliability of the monitoring devices.
  • Areas of improvement include the need to acquire videophone with better resolution for monitoring and improved coordination of the multidisciplinary team.
Funding Source:
Government: James J. Peters Medical Association
Reviewer Comments:
  • Purpose of the study was not described
  • Search strategy was not included
  • Data to be collected was not clearly described
  • Intervention was not clearly described
  • Results were not described
  • Data was not shown in summary tables
  • Limitations of the review was not described.
Quality Criteria Checklist: Review Articles
Relevance Questions
  1. Will the answer if true, have a direct bearing on the health of patients? Yes
  2. Is the outcome or topic something that patients/clients/population groups would care about? Yes
  3. Is the problem addressed in the review one that is relevant to dietetics practice? Yes
  4. Will the information, if true, require a change in practice? Yes
 
Validity Questions
  1. Was the question for the review clearly focused and appropriate? No
  2. Was the search strategy used to locate relevant studies comprehensive? Were the databases searched and the search termsused described? No
  3. Were explicit methods used to select studies to include in the review? Were inclusion/exclusion criteria specified andappropriate? Wereselectionmethods unbiased? No
  4. Was there an appraisal of the quality and validity of studies included in the review? Were appraisal methodsspecified,appropriate, andreproducible? No
  5. Were specific treatments/interventions/exposures described? Were treatments similar enough to be combined? ???
  6. Was the outcome of interest clearly indicated? Were other potential harms and benefits considered? ???
  7. Were processes for data abstraction, synthesis, and analysis described? Were they applied consistently acrossstudies and groups? Was thereappropriate use of qualitative and/or quantitative synthesis? Was variation in findings among studies analyzed? Were heterogeneity issued considered? If data from studies were aggregated for meta-analysis, was the procedure described? No
  8. Are the results clearly presented in narrative and/or quantitative terms? If summary statistics are used, are levels ofsignificance and/or confidence intervals included? No
  9. Are conclusions supported by results with biases and limitations taken into consideration? Are limitations ofthe review identified anddiscussed? No
  10. Was bias due to the review's funding or sponsorship unlikely? Yes