Tele-rehabilitation feasibility trial finds positive results comparable with in-person rehabilitation studies
By Conor Gormally. This article was initially published in our Concussion Update newsletter; please consider subscribing.
A study by Josh Shore et al. found that a novel Tele-Active Rehabilitation (Tele-AR) program improved postconcussion symptoms, illness perception, and occupational performance (self-perception of performance in everyday living) in a small group of adolescents. Adolescents face transportation, financial, and logistical barriers to participating in in-person active rehabilitation therapy. The presence of these barriers is problematic, as active rehabilitation programs involve regular contact between clinician and patient and are individually tailored to patients’ abilities and needs. To address the barriers involved with in-person programs, the authors explored the feasibility and efficacy of a Tele-AR intervention.
The Tele-AR program lasts six weeks and consists of “(1) progressive subsymptom threshold aerobic exercise, (2) sport coordination drills, and (3) comprehensive education and support.” During the study, participants met weekly via video call with a registered kinesiologist who trained participants to do the program independently and provided education, support, and program modifications where appropriate. The study included “three adolescents (ages 14–17 years, n=2 female) who ranged from 5 weeks to 24 weeks postconcussion and continued to experience symptoms at enrollment. One parent participated alongside each adolescent (all mothers).”
The authors note that participants showed improvements in symptom scores and occupational performance comparable with in-person active rehabilitation studies. In addition, “The Tele-AR intervention trains similar self-monitoring skills and provides a structured and supervised exercise programme for those without access to exercise testing or heart rate monitors. High satisfaction ratings and the lack of adverse events reported here suggest that this approach may also be safe and appropriate.”
Further, the participants identified education and support as critical aspects of the program regarding participant satisfaction and illness perceptions. The authors further state that “this study is the first to suggest that illness perception may be responsive to tailored education and support combined with supervised exercise among adolescents with concussion.” Shore et al. emphasize a need for further study but remain optimistic that their research has made meaningful strides in demonstrating the feasibility of Tele-AR for adolescent concussion. The study was published in BMJ Open Sport & Exercise Medicine.