SCI: Role of the Registered Dietitian (2007)
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
Not stated by author.
- 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.
- 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)
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.
Timing of Measurements
- Baseline information to include patient goals.
- With the Health Buddy daily information is sent.
- With the videophones, information is collected weekly.
- Original data was not described in the study
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
James J Peters Veterans Affairs Medical Center, Bronx, NY
- 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.
|Government:||James J. Peters Medical Association|
- 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
|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|
|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|