Biomedical subjects

Tina Butterfield

Publications and source records attributed to Tina Butterfield.

4 recordsLinked to original sources

PubMed2006

The effects of in-home rehabilitation on task self-efficacy in mobility-impaired adults: A randomized clinical trial.

OBJECTIVES: To examine the effect on mobility self-efficacy of a multifactorial, individualized, occupational/physical therapy (OT/PT) intervention delivered via teletechnology or in-home visits. DESIGN: Randomized, clinical trial. SETTING: One Department of Veterans Affairs and one private rehabilitation hospital. PARTICIPANTS: Sixty-five community-dwelling adults with new mobility devices. Thirty-three were randomized to the control or usual care group (UCG), 32 to the intervention group (IG). INTERVENTION: Four, once-weekly, 1-hour OT/PT sessions targeting three mobility and three transfer tasks. A therapist delivered the intervention in the traditional home setting (trad group n = 16) or remotely via teletechnology (tele group n = 16). MEASUREMENTS: Ten-item Likert-scale measure of mobility self-efficacy. RESULTS: The IG had a statistically significantly greater increase in overall self-efficacy over the study period than the UCG (mean change: IG 8.8, 95% confidence interval (CI) = 3.8-13.7; UCG 1.2, 95% CI = -5.8-8.2). Descriptively, the IG exhibited positive changes in self-efficacy for all tasks and greater positive change than the UCG on all items with the exception of getting in and out of a chair. Comparisons of the two treatment delivery methods showed a medium standardized effect size (SES) in both the tele and trad groups, although it did not reach statistical significance for the tele group (SES: tele = 0.35, 95% CI = -2.5-0.95; trad = 0.54, 95% CI = 0.06-1.14). CONCLUSION: A multifactorial, individualized, home-based OT/PT intervention can improve self-efficacy in mobility-impaired adults. The trend toward increased self-efficacy irrespective of the mode of rehabilitation delivery suggests that telerehabilitation can be a viable alternative to or can augment traditional in-home therapy.

Activities of Daily Living↗

PubMed2005

Using remote assessment to provide home modification services to underserved elders.

PURPOSE: Although remote home assessment would enable specialists to prescribe home modifications for anyone, anywhere, the strategy is dependent on the ability to provide specialists with the same information as an in-home assessment. The purpose of this paper is to document that remote assessment is feasible and concurs largely with traditional in-home assessment based on expert judgment. DESIGN AND METHODS: We compared two new remote assessments, a "zero-tech" paper-and-pencil protocol and a "high-tech" televideo protocol, to traditional in-home assessments to determine the equivalence of the remote and in-home assessments. We determined equivalence by comparing each of the remote assessments to a traditional in-home assessment in the same home. In-home assessments were conducted by home-modification specialists in all homes. Data collection for the remote protocols was conducted by individuals inexperienced in home modification. Assessment data from the remote protocols were analyzed by specialists to diagnose problems and prescribe solutions. RESULTS: The overall rates of correct problem identification (i.e., Sensitivity + Specificity) were significant (p =.000) for both the remote paper-and-pencil (96.4%) and remote televideo (87.1%) protocols. Similarly, rates of agreement in recommendations of solutions were significant (p =.000) for both remote assessments (78.8% and 77.4%, respectively). IMPLICATIONS: The need for home-modification services, particularly in rural areas, far exceeds the capacity of specialists to provide them. Our findings suggest that remote assessments can potentially be used to identify mobility and safety problems in the home as well as to recommend solutions to those problems. As a result, remote home assessment has the potential to provide underserved elders with access to home-modification services that have heretofore eluded them.

Aged↗

PubMed2004

Using telerehabilitation to identify home modification needs.

Teleconferencing technology has great potential for providing cost-effective in-home assessment for home modification services from anywhere to anyone in need. Despite its enormous potential, the use of this technology as a means to deliver these specific services had not been investigated. This project investigated the use of televideo technology to provide remote home assessment services to patients prior to discharge so that they could function as independently as possible in their own homes after being discharged from a specialty clinic. Specifically, an assessment protocol that could be implemented using video-conferencing technology was developed and feasibility of the remote assessment process was determined by validating it against the standard of practice, an in-home assessment by a home modifications specialist. Independent in-home and remote home assessments were completed by two occupational therapists who specialize in home modifications. The results were compared for agreement in identification of specific accessibility problems in and quantitative measurements of the home. The remote assessment correctly identified a total of 51 of the 59 problems (86.4%) identified by the in-home assessment and only identified five problems (8.9%) that were not identified by the on-site assessment. In addition, 54 of 60 (90%) of the quantitative measurements from the remote assessment matched those from the in-home assessment. Findings suggest that remote telerehabilitation assessments have the potential to enable specialists to diagnose potential accessibility problems in home environments and prescribe appropriate modifications regardless of the location of the client, home, or specialist.

Architectural Accessibility↗

PubMedDate not supplied

Development of a teletechnology protocol for in-home rehabilitation.

Our ability to provide in-home rehabilitation is limited by distance and available personnel. We may be able to meet some rehabilitation needs with videoconferencing technology. This article describes the feasibility of teletechnology for delivering multifactorial, in-home rehabilitation interventions to community-dwelling adults recently prescribed a mobility aid. We used standard telephone lines to provide two-way video and audio interaction. The interventions included prescription of and/or training in functionally based exercises, home-hazard assessment, assistive technology, environmental modifications, and adaptive strategies. Patients were evaluated in three transfer and three mobility tasks, and appropriate treatment was provided over the course of four visits. To date, 13 of the 14 subjects enrolled in the rehabilitation study have completed all four visits (56 visits total). Equipment-related problems were most common early in the study, particularly on the initial visit to a subject's house. We identified (mean +/- standard deviation [SD]) 13.1 +/- 7.9 mobility/self-care problems per subject and made 12.5 +/- 8.3 recommendations per subject to address those problems. At 6-week follow-up, 60.1 percent of our recommendations had been implemented. The greatest number of problems was identified for tub transfers (mean +/- SD = 3.4 +/- 1.4), the greatest number of recommendations was made for toilet transfers (mean +/- SD = 3.1 +/- 3.4), and the most frequently implemented recommendations were for transition between locations. Overall, our results show promise that both the telerehabilitation technology and intervention procedures are feasible.

Biomedical Technology↗