Home Telerehabilitation for Deconditioned Older Adults

Study Overview
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Brief Summary
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The purpose of this study is to develop a home exercise program for patients 60 years of age and over who are deconditioned following their discharge from the hospital, or recruited from GLA outpatient clinics. The program will be designed to monitor and improve patients' exercise behavior through the use of home technology, such as text messaging monitors.

Detailed Description
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The aim of this study is to develop and determine the feasibility of implementing a home exercise and functional status monitoring telerehabilitation program, known as TEL-REHAB, for older adults 60 years of age and over who are deconditioned following their discharge from the inpatient setting, or recruited from GLA outpatient clinics. Deconditioning is a modifiable risk factor for preventing institutionalization of frail elderly patients who would otherwise be able to live independently. Home exercise programs are an effective intervention to reduce the risk, but patient compliance with home exercise programs, and assessments of patients during home exercise programs, are barriers to achieving maximal benefits. Face-to-face visits with physical medicine professionals are an effective means to perform these functions, but are problematic because of professional time impacts and patient transportation problems. A TEL-REHAB program will empower these patients to take responsibility for their own health by providing ongoing communication with a healthcare provider. In this way, telerehabilitation may assist older adults to remain independent in their homes as long as possible.

Official Title
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Home Based Telerehabilitation for Deconditioned Older Adults

Conditions
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Osteoarthritis

Intervention / Treatment
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* Device: Health Buddy, Home telehealth technology
* Other: Telephone counseling


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: acute decline in functional status while hospitalized as reported by the patient physically inactive outpatients (exercise less than 30 min/day, 3 d/wk) ability to hear and communicate via telephone ability to read a video or text monitor ability to manually operate the technology have a working telephone and power source willingness to use the TEL-REHAB technology Exclusion Criteria: does not speak English poor cognition as determined by the Mini-Cog non-ambulatory had a stroke, myocardial infarction, hip fracture, or total hip or knee replacement within the prior 6 months

Ages Eligible for Study
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Minimum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Health Buddy outpatient<br>Received home telehealth monitoring by Health Buddy | Device: Health Buddy, Home telehealth technology<br>* Exercise questions, educational messages, and clinical reminders have been programmed into the home telehealth technology and are administered daily via the Health Buddy(R) to evaluate the program's feasibility based on adherence rates, program completion rates, and safety.<br>|
| Experimental: Telephone outpatient<br> | Other: Telephone counseling<br> <br> |
| Experimental: health buddy inpatient<br> | Device: Health Buddy, Home telehealth technology<br>* Exercise questions, educational messages, and clinical reminders have been programmed into the home telehealth technology and are administered daily via the Health Buddy(R) to evaluate the program's feasibility based on adherence rates, program completion rates, and safety.<br>|
| Experimental: telephone inpatient<br> | Other: Telephone counseling<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Exercise Adherence | An 11-week exercise adherence rate was calculated by dividing the total number of days that the participant reported exercising by 77 days and multiplying by 100. This first calculation estimated the exercise adherence rate for the full intervention period regardless of participant dropout. Eleven weeks rather than 12 weeks was used in the denominator because subjects received their HB units some time during the first week of study enrollment and may have missed some days during this first week. | at monthly intervals, for 3-months | 
| HB/Phone Adherence | An 11-week text messaging or phone adherence rate was calculated by dividing the number of response days via the HB or phone divided by 77 days and multiplied by 100. This first calculation estimated the text messaging or phone adherence rate for the full intervention period regardless of participant dropout. Eleven weeks rather than 12 weeks was used in the denominator because subjects received their HB units some time during the first week of study enrollment and may have missed some days during this first week. | Monthly over 3 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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telehealth, telerehabilitation, deconditioning, exercise