About this Research Topic
In recent years, the hospitalization period of neurological patients has become shorter and a great part of the rehabilitative phase has become more and more focused towards outpatient settings. However, a high percentage of discharged patients still do not receive adequate rehabilitation. Resources are limited, and the possibility for an individual to receive adequate rehabilitative services often depends on non-clinical factors such as resource availability, geographical location, age, and personal wealth. The benefits obtained during hospital rehabilitation are often not sustained in the long term, as people reduce activity and cease engagement in exercises, leading to functional deterioration. To face these difficulties, Tele-NeuroRehabilitation (TNR) can provide treatment to home bound subjects, without displacing therapists or patients. Many studies have highlighted the fact that a rehabilitative treatment produces equivalent results whether it is delivered face-to-face or from a distance, confirming that TNR can be effectively used to answer the growing demand for improved home care. Despite these results, TNR has not yet been integrated in routine territorial rehabilitative treatments (UTRT), since some key points, such as the lack of common and shared methodologies for the delivery of TNR treatments and the wide range of possible TNR services (including tele-counselling, tele-care, tele-monitoring and tele-therapy) have yet to be analysed further.
TNR could be very important and powerful for neurological patients, as its services can be delivered along the entire lifespan of the patient, creating a continuum in the care process. However, managing clinical complexity implies that TNR should not only be considered as a specific way to provide care, but it is also a wide-branched field of study. In the past most studies on TNR were pilot studies or small projects, the results of which cannot be extended to a large population. The need for studies to further investigate the effectiveness of many different clinical interventions – motor, cognitive, speech – in many different clinical pathologies is compelling. Furthermore, the cost-benefit ratio of TNR, compared to UTRT or to prolonged hospitalization, has yet to be deeply analysed.
The current research in this field is now growing and this Research Topic will be a platform for publications of such research. The aim of this collection is to present an update on the state of knowledge and expertise in the field of Tele-Rehabilitation for neurological patients. Therefore, we welcome submissions of Original Research, Reviews, and Case Reports on the following areas:
- Comparison of the effectiveness of TNR with that of UTRT, on different homogeneous groups of patients;
- Feasibility, availability and effectiveness of TNR treatments in different clinical areas;
- TNR for children and adolescents;
- Usefulness of TNR for limiting prolonged hospitalization;
- Continuity of care in patients with chronic and degenerative neurological diseases;
- Home care monitoring from afar, for patients with severe neurological pathologies;
- Comparison of costs of TNR with that of UTRT and that of prolonged hospitalization;
- Feasibility, availability and effectiveness of new technological devices to be used from afar, including wearable devices;
- Experiences of TNR networks and services.
Keywords: Tele-Rehabilitation, Tele-NeuroRehabilitation, Tele-Medicine, Neurological Disease, eHealth, Home Care
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