title: A Telemedicine Service as Partial Replacement of Face-to-Face Physical Rehabilitation: The Relevance of Use.
abstract: BACKGROUND
  Different kinds of telemedicine services have made their entry into healthcare. In this article we focus on a telerehabilitation service for physical exercise, designed and implemented as partial replacement of a 3-day outpatient rehabilitation program for chronic disease patients. The aim of this article is to examine the use pattern of this telerehabilitation service by chronic disease patients and to examine the association between actual use and clinical benefit experienced by these patients.
  
  
  METHODS
  Chronic lower back pain (CLBP) patients and pulmonary disease (PD) patients referred to the physical outpatient rehabilitation programs were asked to participate in and to use the telerehabilitation service. The actual use was expressed as frequency and duration of use, and the measurement of clinical benefit focused on complaints and physical functioning.
  
  
  RESULTS
  Sixty-two patients finished the outpatient rehabilitation using the telerehabilitation service. During the weeks of home rehabilitation the majority of the patients used the service. On average the service was used one or two times a week for a total of 35-38 min for both pathologies, with this value being lower than the time that was replaced. Frequency of use was significantly associated with the change in physical functioning outcome for both pathologies (CLBP, r=0.41, p=0.02; PD, r=0.55, p=0.003).
  
  
  CONCLUSIONS
  Chronic disease patients used a telerehabilitation service as partial replacement of their face-to-face rehabilitation program, and more frequent use was positively related to higher clinical benefit.
authors.affiliation: 1 Telemedicine Group , Roessingh Research and Development, Enschede, The Netherlands .
authors.forename: Stephanie
authors.initials: S
authors.lastname: Jansen-Kosterink
authors.affiliation: 1 Telemedicine Group , Roessingh Research and Development, Enschede, The Netherlands .
authors.forename: Rianne Huis
authors.initials: RH
authors.lastname: In 't Veld
authors.affiliation: 1 Telemedicine Group , Roessingh Research and Development, Enschede, The Netherlands .|2 Telemedicine Group, Faculty of Electrical Engineering, Mathematics, and Computer Science, University of Twente , Enschede, The Netherlands .
authors.forename: Hermie
authors.initials: H
authors.lastname: Hermens
authors.affiliation: 1 Telemedicine Group , Roessingh Research and Development, Enschede, The Netherlands .|2 Telemedicine Group, Faculty of Electrical Engineering, Mathematics, and Computer Science, University of Twente , Enschede, The Netherlands .
authors.forename: Miriam
authors.initials: M
authors.lastname: Vollenbroek-Hutten
mesh_terms: D000328:Adult; D000368:Aged; D059350:Chronic Pain / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000534:rehabilitation*; D008171:Lung Diseases / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D012648:Self Care / Q000379:methods*; D000069350:Telerehabilitation / Q000379:methods*; D013997:Time Factors
keywords: actual use; chronic disease patients; compliance; physical rehabilitation; telemedicine; telerehabilitation