Multicomponent telerehabilitation programme for older veterans with multimorbidity: a programme evaluation

• Published in: BMJ military health Vol. 171; no. 1; pp. 33 - 39
• Main Authors: Rauzi, Michelle R, Abbate, L M, Lum, H D, Cook, P F, Stevens-Lapsley, J E
• Format: Journal Article
• Language: English
• Published: England British Medical Journal Publishing Group 01.02.2025; BMJ Publishing Group LTD
• Subjects: Aged; Aged, 80 and over; Chronic illnesses; Coaching; Comorbidity; Emergency medical care; Exercise; Feasibility; Female; GERIATRIC MEDICINE; Health & safety; Humans; Intervention; Loneliness; Male; Middle Aged; Multimorbidity; Original research; Patient safety; Patient satisfaction; Physical therapists; Physical therapy; Program Evaluation - methods; Rehabilitation; REHABILITATION MEDICINE; Social support; Telemedicine; Telerehabilitation - standards; Telerehabilitation - statistics & numerical data; Text messaging; Veterans - psychology; Veterans - statistics & numerical data; United States > US; Health & safety; Telemedicine; REHABILITATION MEDICINE; GERIATRIC MEDICINE
• ISSN: 2633-3767; 2633-3775; 2633-3775
• DOI: 10.1136/military-2023-002535

IntroductionOlder veterans with multimorbidity experience physical, mental and social factors which may negatively impact health and healthcare access. Physical function, behaviour change skills and loneliness may not be addressed during traditional physical rehabilitation. Thus, a multicomponent telerehabilitation programme could address these unmet needs. This programme evaluation assessed the safety, feasibility and change in patient outcomes for a multicomponent telerehabilitation programme.MethodsIndividuals were eligible if they were a veteran/spouse, age ≥50 years and had ≥3 comorbidities. The telerehabilitation programme included four core components: (1) High-intensity rehabilitation, (2) Coaching interventions, (3) Social support and (4) Technology. Physical therapists delivered the 12-week programme and collected patient outcomes at baseline, 4 weeks, 8 weeks and 12 weeks. Programme evaluation measures included safety events (occurrence and type), feasibility (adherence) and patient outcomes (physical function). Safety and feasibility outcomes were analysed using descriptive statistics. The mean pre-post programme difference and 95% CI for patient outcomes were generated using paired t-tests.ResultsTwenty-one participants enrolled in the telerehabilitation programme; most were male (81%), white (72%) and non-Hispanic (76%), with an average of 5.7 (3.0) comorbidities. Prevalence of insession safety events was 3.2% (0.03 events/session). Fifteen (71.4%) participants adhered to the programme (attended ≥80% of sessions). Mean (95% CI) improvements for physical function are as follows: 4.7 (2.4 to 7.0) repetitions for 30 s sit to stand, 6.0 (4.0 to 9.0) and 5.0 (2.0 to 9.0) repetitions for right arm curl and left arm curl, respectively, and 31.8 (15.9 to 47.7) repetitions for the 2 min step test.ConclusionThe telerehabilitation programme was safe, feasible and demonstrated preprogramme to postprogramme improvements in physical function measures while addressing unmet needs in a vulnerable population. These results support a randomised clinical trial while informing programme and process adaptations.