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The effectiveness of affordable technology in rehabilitation to improve mobility and physical activity: Amount (activity and mobility using technology) rehabilitation trial - 15/07/18

Doi : 10.1016/j.rehab.2018.05.184 
C. Sherrington 1, , L. Hassett 1, 2, M. van den Berg 3, R. Lindley 4, M. Crotty 3, A. McCluskey 2, H. van der Ploeg 5, S. Smith 6, K. Schurr 7
1 The University of Sydney, Musculoskeletal Health Sydney, Sydney, Australia 
2 The University of Sydney, Faculty of Health Sciences, Sydney, Australia 
3 Flinders University, Rehabilitation, Aged & Extended Care, Adelaide, Australia 
4 The University of Sydney, Westmead Clinical School, Sydney, Australia 
5 VU University Medical Center Amsterdam, Department of Public & Occupational Health and EMGO+Institute for Health and Care Research, Amsterdam, The Netherlands 
6 Southern Cross University, Coffs Harbour campus, Coffs Harbour, Australia 
7 South Western Sydney Local Health District, Bankstown-Lidcombe Hospital, Sydney, Australia 

Corresponding author.

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Résumé

Introduction/Background

Technology may enable a higher dose of exercise to improve rehabilitation outcomes.

Aim

To evaluate the effect of the addition of affordable technology to usual care on physical activity and mobility in people with mobility limitations admitted to inpatient aged and neurological rehabilitation compared to usual care alone.

Material and method

A pragmatic, assessor-blinded, parallel-group randomised trial of 300 consenting rehabilitation inpatients. The intervention group received technology-based exercise prescribed by a physiotherapist to target mobility and physical activity problems for 6 months. Technology included video and computer games/exercises, tablet applications and activity monitors. The control group received no additional intervention and both groups received usual rehabilitation care. The co-primary outcomes were objectively assessed physical activity (averageminutes per day spent upright using activPAL) and mobility (Short Physical Performance Battery, SPPB, 0–3 continuous score) at 6 months after randomisation. Linear models assessed the effect of group allocation with baseline scores entered as covariates.

Results

Participants (mean age 74 (SD14); 50% female; 54% with neurological conditions limiting mobility) received on average 11 (SD11) inpatient sessions using 4 (SD1) different technologies and 15 physiotherapy contacts to support technology use in the post-hospital phase. At 6-months physical activity was similar between groups (mean between group difference (95% CI) uptime in minutes: −3.1 (−39.4 to 33.2; P=0.87)) and mobility was significantly better in the intervention group compared to the control group (mean SPPB between group change score 6-month to baseline 0.2 points (95% CI 0.1 to 0.3, P<0.01)). Secondary outcomes of mobility also favoured the intervention group as did other aspects of physical activity (e.g. self-reported physical activity), particularly for younger participants.

Conclusion

A tailored intervention using technology, targeting specific mobility limitations and promoting physical activity in addition to usual rehabilitation, improved mobility and some aspects of physical activity and appears to have greater impact in younger people.

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Keywords : Mobility, Technology, Physical activity


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Vol 61 - N° S

P. e86 - juillet 2018 Retour au numéro
Article précédent Article précédent
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