Telerehabilitation of Patients with Injuries of the Lower Extremities.
Timely access to orthopedic rehabilitation is an important problem for the Ukrainian healthcare system. The international orthopedic community aims to achieve the best possible outcome for patient care by modifying rehabilitation methods and using telemedicine technology. The theme of this article is to discuss the integration of telemedicine technology in the rehabilitation of patients with injuries of the lower extremities. Consecutive patients were recruited over a 2-year period. A total of 74 subjects with lower extremity injuries were enrolled in the study and monitored during a 3-month period. Twenty-six patients from the control group underwent traditional rehabilitation procedures for a 3-month period after injury. A total of 48 subjects were enrolled in the telerehabilitation group for a 3-month study period and were trained with a set of exercises for home use. Home remote monitoring for the 48 test subjects included use of a smartphone with gyroscope, G-sensor, magnetometer, and barometer, which was fixed to the injured limb. Software for the smartphone was developed at the I. Horbachevsky Ternopil Medical University, Ukraine. Software permits the monitoring of exercise time, the frequency of active movements of the injured limb, the number of steps per hour, and the walking speed. The 3-month rehabilitation period started with the power load of 10% of body weight, following 3-5 steps five times per day with a speed no >1 km/h. The orthopedic surgeon, during telerehabilitation, took significantly less time to consult patients (2.3 min ± 0.4) than the traditional rehabilitation (12.6 min ± 2.9). Patient satisfaction was higher for the telerehabilitation (83.1% ± 14.2) than for the orthopedic surgeon's traditional rehabilitation (33.1% ± 8.9). Telerehabilitation is a good alternative for providing access to specialty care for the growing number of patients with traumatic injuries.