Telerehabilitation for community-dwelling middle-aged and older adults after musculoskeletal trauma: A systematic review

Background: Musculoskeletal trauma at midlife and beyond imposes significant impact on function and quality of life: Rehabilitation is key to support early and sustained recovery. There are frequent barriers to attending in-person rehabilitation that may be overcome by the recent advances in technology (telerehabilitation). Therefore, we conducted a systematic review of published evidence on telerehabilitation as a delivery mode for adults and older adults with musculoskeletal trauma. Methods: We followed established guidelines for conducting and reporting systematic reviews. We searched the following databases up to June 23, 2018: Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Embase, Google Scholar, MEDLINE (Ovid and PubMed), PsycINFO, and SportDiscus. We included publications across all available years and languages for community-dwelling adults (50 years and older) with musculoskeletal trauma; and interventions using the following delivery modes: Apps, computer, telephone, videophone, videoconference, webcam, webpage, or similar media. Results: Six studies met the inclusion criteria: Five studies for hip fracture (n = 260) and one study for proximal humeral fracture rehabilitation (n = 17). Four of the studies used telephone as the delivery mode, one used computer and another used video-conferencing. Two of the studies were pre-post with no comparator group, and the remaining four studies were randomized controlled trials with low or unclear risk of bias. Studies established some modes of remote delivery as feasible, but the generalizability of the findings were limited. Two studies observed significant between-group differences (favoring the intervention) for physical activity, quality of life, and self-efficacy. Conclusion: Very few studies exist that tested the effect of telerehabilitation for recovery after musculoskeletal trauma later in life. Given the global burden imposed by musculoskeletal trauma, this review underscores an important gap in clinical knowledge

Exploring behavior change techniques for reablement: A scoping review.

Reablement is a team-based person-centered health and social care model, most commonly available for community-dwelling older adults. Understanding the components of reablement and how it is delivered, received, and enacted facilitates best evidence and practice. Determining behavior change techniques (BCTs) or strategies is an important step to operationalize implementation of reablement. We conducted a scoping review of peer-reviewed literature to identify BCTs used within reablement studies. We registered our study with the Joanna Briggs Institute and conducted five database searches. Inclusion criteria were peer-reviewed studies focused on adults and older adults without significant cognitive impairment or dementia receiving reablement, and all study designs, years, and languages. We excluded studies focused on reablement for people with dementia or reablement training programs. The last search was on April 8, 2021. Two authors screened independently at Level 1 (title and abstract) and 2 (full text). Two authors adjudicated BCTs for each study, and a third author confirmed the final list. We identified 567 studies (591 publications) and included 21 studies (44 publications) from six global locations. We identified 27 different BCTs across all studies. The three most common BCTs for reablement were goal setting (behavior), social support (unspecified), and instruction on how to perform a behavior. We highlight some behavioral components of reablement and encourage detailed reporting to increase transparency and replication of the intervention. Future research should explore effective BCTs (or combinations of) to include within reablement to support health behavior adoption and maintenance