Basado en ensayos clínicos

Resultados en 663 pacientes publicados en la prestigiosa «Archives of Physical Medicine and Rehabilitation».

Con una muestra de 663 pacientes, los ensayos han demostrado una recuperación clínica más rápida cuando los pacientes se trataron con ReHand, en comparación con el tratamiento convencional. Además, se observó una optimización en la gestión de recursos asistenciales del hospital. Aquellos pacientes tratados con ReHand necesitaron una media de nueve sesiones menos de fisioterapia y de dos consultas menos de rehabilitación, observándose a su vez una reducción del 41% de la tasa de derivación de estos pacientes al servicio de rehabilitación, lo que impacta en la lista de espera. En concreto, se estimó un ahorro medio para rehabilitación de 670€ por paciente.

Resultados completos aquí: https://pubmed.ncbi.nlm.nih.gov/36758713/

Abstract

Objective: To assess whether, in patients with bone and soft tissue injuries of the wrist, hand and/or fingers treated by public health services, feedback-guided exercises performed on a tablet touchscreen improve clinical recovery and reduce healthcare usage, more than the conventional home exercise program prescribed on paper.

Design: A multicentre assessor-blinded, parallel, two-group, controlled trial.

Setting: Trauma and rehabilitation services of four hospitals.

Participants: 663 patients with limited functional ability due to bone and soft tissue injuries of the wrist, hand and/or fingers.

Interventions: Experimental group (EG) received a home exercise program using a tablet-based application with feedback, monitoring and progression; while control group (CG) received an evidence-based home exercise program on paper.

Main outcome measure(s): The primary outcome was functional ability through Patient-Rated Wrist Evaluation (PRWE) for wrist conditions and QuickDASH for the rest of hand pathologies. Secondary outcomes included: dexterity, pain intensity, and grip strength and healthcare usage (number of patients referred to rehabilitation service and number of clinical appointments).

Results: The EG showed a significant improvement on PRWE (p=.001) and QuickDASH (p=.001) with medium effect sizes (η²=0.066-0.067) when compared with the CG. Regarding healthcare usage, the EG presented a reduction of 41% in the rate of referrals to face-to-face rehabilitation service consultations, a reduction of rehabilitation consultations (MD -1.64, 95% CI – 2.64 to -0.65) and physiotherapy sessions (MD -8.52, 95% CI -16.92 to -0.65) compared to the CG.

Conclusions: In patients with bone and soft tissue injuries of the wrist, hand and/or fingers, prescribing feedback-guided exercises performed on a tablet touchscreen was more effective for improving patients´ functional ability and reduces number of patients referred to rehabilitation consultation and number of clinical appointments.

Keywords: Exercise therapy; Health Resources; Mobile applications; Telerehabilitation; physical therapy.