Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Dec;59(S 02):e90-e99.
doi: 10.1055/s-0040-1713685. Epub 2020 Aug 10.

Health-Enabling Technologies for Telerehabilitation of the Shoulder: A Feasibility and User Acceptance Study

Bianca Steiner  1 , Lena Elgert  2 , Birgit Saalfeld  2 , Jonas Schwartze  2 , Horst Peter Borrmann  3 , Axel Kobelt-Pönicke  4 , Andreas Figlewicz  5 , Detlev Kasprowski  5 , Michael Thiel  5 , Ralf Kreikebohm  6 , Reinhold Haux  1 , Klaus-Hendrik Wolf  2
Affiliations

Health-Enabling Technologies for Telerehabilitation of the Shoulder: A Feasibility and User Acceptance Study

Bianca Steiner et al. Methods Inf Med. 2020 Dec.

Abstract

Background: After discharge from a rehabilitation center the continuation of therapy is necessary to secure already achieved healing progress and sustain (re-)integration into working life. To this end, home-based exercise programs are frequently prescribed. However, many patients do not perform their exercises as frequently as prescribed or even with incorrect movements. The telerehabilitation system AGT-Reha was developed to support patients with shoulder diseases during their home-based aftercare rehabilitation.

Objectives: The presented pilot study AGT-Reha-P2 evaluates the technical feasibility and user acceptance of the home-based telerehabilitation system AGT-Reha.

Methods: A nonblinded, nonrandomized exploratory feasibility study was conducted over a 2-year period in patients' homes. Twelve patients completed a 3-month telerehabilitation exercise program with AGT-Reha. Primary outcome measures are the satisfying technical functionality and user acceptance assessed by technical parameters, structured interviews, and a four-dimensional questionnaire. Secondary endpoints are the medical rehabilitation success measured by the active range of motion and the shoulder function (pain and disability) assessed by employing the Neutral-0 Method and the standardized questionnaire "Shoulder Pain and Disability Index" (SPADI), respectively. To prepare an efficacy trial, various standardized questionnaires were included in the study to measure ability to work, capacity to work, and subjective prognosis of work capacity. The participants have been assessed at three measurement points: prebaseline (admission to rehabilitation center), baseline (discharge from rehabilitation center), and posttherapy.

Results: Six participants used the first version of AGT-Reha, while six other patients used an improved version. Despite minor technical problems, all participants successfully trained on their own with AGT-Reha at home. On average, participants trained at least once per day during their training period. Five of the 12 participants showed clinically relevant improvements of shoulder function (improved SPADI score > 11). The work-related parameters suggested a positive impact. All participants would recommend the system, ten participants would likely reuse it, and seven participants would have wanted to continue their use after 3 months.

Conclusion: The findings show that home-based training with AGT-Reha is feasible and well accepted. Outcomes of SPADI indicate the effectiveness of aftercare with AGT-Reha. A controlled clinical trial to test this hypothesis will be conducted with a larger number of participants.

PubMed Disclaimer

Conflict of interest statement

This work is part of the collaborative research project AGT-Reha funded by the Deutsche Rentenversicherung Braunschweig-Hannover. They provided hardware and support for the study described in the manuscript. There are no other individual conflicts of interest.

Figures

Fig. 1
Fig. 1
Training scene in AGT-Reha-V1 (left) and AGT-Reha-V2 (right) in comparison.
Fig. 2
Fig. 2
Boxplot in combination with a violin plot. Changes in shoulder mobility per movement direction in angular degrees (T1–T2).
See this image and copyright information in PMC

References

    1. Woolf A D, Erwin J, March L. The need to address the burden of musculoskeletal conditions. Best Pract Res Clin Rheumatol. 2012;26(02):183–224. - PubMed
    1. Robert Koch-Institut. Gesundheit in Deutschland. Gesundheitsberichterstattung des Bundes. Gemeinsam getragen von RKI und Destatis Berlin: H.Heenemann GmbH & Co. KG; 2015[German]
    1. BARMER GEK. Gesundheitsreport 2014 Niedersachsen Berlin: BARMER GEK; 20148–75.[German]
    1. Mitchell C, Adebajo A, Hay E, Carr A.Shoulder pain: diagnosis and management in primary care BMJ 2005331(7525):1124–1128. - PMC - PubMed
    1. Deutsche Rentenversicherung. Reha-Bericht 2018: Die medizinische und berufliche Rehabilitation der Rentenversicherung im Licht der Statistik Berlin: Deutsche Rentenversicherung Bund; 2018[German]

Publication types