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      Demystifying the Digital Divide: Disparities in Telerehabilitation Readiness Among Older Adults in the United States

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      Archives of Physical Medicine and Rehabilitation
      Elsevier BV

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          Assessing Telemedicine Unreadiness Among Older Adults in the United States During the COVID-19 Pandemic

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            A Double Burden of Exclusion? Digital and Social Exclusion of Older Adults in Times of COVID-19

            Abstract The COVID-19 pandemic has excluded older adults from a society based on physical social contact. Vulnerable populations like older adults also tend to be excluded from digital services because they opt not to use the internet, lack necessary devices and network connectivity, or inexperience using the technology. Older adults who are frail and are not online, many of whom are in long-term care facilities, struggle with the double burden of social and digital exclusion. This paper discusses the potential outcomes of this exclusion and provides recommendations for rectifying the situation, with a particular focus on older adults in long-term care facilities.
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              Is Open Access

              Effectiveness of telerehabilitation in physical therapy: A rapid overview

              Abstract Objective The purpose of this article was to summarize the available evidence from systematic reviews on telerehabilitation in physical therapy. Methods Medline/Pubmed, EMBASE and Cochrane Library databases. In addition, the records in PROSPERO and Epistemonikos and PEDro were consulted. Systematic reviews of different conditions, populations and contexts, where the intervention to be evaluated is telerehabilitation by physical therapy were included. The outcomes were clinical effectiveness depending on specific condition, functionality, quality of life, satisfaction, adherence and safety. Data extraction and risk of bias assessment were carried out by a reviewer with non-independent verification by a second reviewer. The findings are reported qualitatively by tables and figures. Results Fifty-three systematic reviews were included of which 17 were assessed as having low risk of bias. Fifteen reviews were on cardiorespiratory rehabilitation, 14 on musculoskeletal conditions and 13 on neurorehabilitation. Other 11 reviews addressed other types of conditions and rehabilitation. Thirteen reviews evaluated with low risk of bias showed results in favor of telerehabilitation versus in-person rehabilitation or no-rehabilitation, while 17 reported no differences between the groups. Thirty-five reviews with unclear or high risk of bias showed mixed results. Conclusions Despite the contradictory results, telerehabilitation in physical therapy could be comparable to in-person rehabilitation or better than no-rehabilitation for conditions such as osteoarthritis, low back pain, hip and knee replacement, multiple sclerosis, and also in the context of cardiac and pulmonary rehabilitation. It is imperative to conduct better quality clinical trials and systematic reviews. Impact Providing with the best available evidence on the effectiveness of telerehabilitation to professionals, mainly physical therapists, will impact the decision-making process and therefore better clinical outcomes for patients, both in these times of covid-19 pandemic and in the future. The identification of research gaps will also contribute to the generation of relevant and novel research questions.
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                Author and article information

                Contributors
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                Journal
                Archives of Physical Medicine and Rehabilitation
                Archives of Physical Medicine and Rehabilitation
                Elsevier BV
                00039993
                July 2024
                July 2024
                : 105
                : 7
                : 1255-1261
                Article
                10.1016/j.apmr.2024.03.009
                38554795
                e9ec1f92-12f5-494a-ab8e-4f29e0bfd14c
                © 2024

                https://www.elsevier.com/tdm/userlicense/1.0/

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