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PA Hospital physiotherapist Rita Hwang has found tele-rehabilitation to be just as effective as traditional hospital outpatient-based rehabilitation for chronic heart failure patients.
The pioneering study, published in the Australian Physiotherapy Association’s Journal of Physiotherapy, was the first to test a group-based video tele-rehabilitation program delivered into patients’ homes.
Ms Hwang said the has found telehealth virtual class was just as effective for improving exercise capacity, strength and quality of life in chronic heart failure patients, and even had a better attendance rate.
“There were comparable improvements in their function and quality of life across both groups, but the ones attending the tele-rehabilitation program had higher attendance rates,” she said.
The control group received a traditional heart failure physiotherapy-led rehabilitation program spanning 12 weeks.
Patients visiting the outpatient program completed 60 minutes of prescribed exercise twice weekly, plus education sessions delivered by a multidisciplinary team, including a nurse, dietitian, physiotherapist, occupational therapist, social worker and pharmacist.
In comparison, the tele-rehabilitation group’s program was delivered twice-weekly for 12 weeks via videoconferencing to groups of up to four participants in their own homes.
Educational topics were delivered as electronic slide presentations with embedded audio files and patients were asked to watch the presentations in their own time, which were followed up with online group discussions.
“The patients would be talking to each other and encouraging each other—like what you see in a normal exercise class,” she says.
Ms Hwang said she embarked on research after realising transportation time and travel costs to hospital were major hurdles to patient participation in traditional group classes.
“Some of my patients just live too far to come to our exercise program at the hospital, so I wondered if I could find another way for them to be exercising under the right environment,” she said.
“In the past, I might get them to exercise at home and I’ll just do some follow up. I thought there must be another way to deliver an exercise program where the patients can see one another and provide some peer support. I thought telehealth might be a solution.
“We really need to find other ways to connect more patients to this fantastic heart failure rehabilitation program. I think telehealth might be one of the ways to try and get patients to come in.”
Despite some initial reservations about how physiotherapy practice would translate via an online tele-rehabilitation system, Ms Hwang said physiotherapists were able to watch participants perform exercises and deliver feedback in real time.
She said the initiative was such a success, PAH is now considering ways to translate some of the research findings into clinical practice.
“I’ve also had interest from other colleagues looking at implementing a similar program for their service but it’s still early stages,” she said.