The effect of tele-rehabilitation on the participation of people with spinal cord injury: secondary analysis from a randomized controlled trial

Due to participation being the main goal of rehabilitation in people with spinal cord injury, the distribution of services via telerehabilitation will be useful for most of these people who are no access to rehabilitation centers due to environmental barriers. Therefore, the aim of this research was to investigate the effect of telerehabilitation focused on transfer training and wheelchair mobility on the participation level of people with spinal cord injuries.

In a single-blind randomized controlled clinical trial, people with spinal cord injuries were randomly assigned to intervention and control groups. The intervention group received group and online training in 4 sessions during 4 weeks, so two-hour sessions were held every week. The control group did not receive any intervention. The wheelchair outcome measure (WhOM) was completed by the participants before and after the intervention. The WhOM has two parts, the first part consists of a semi-structured interview and the participants specified their goals based on participation at home (question 1) and in the community or outside the home (question 2). Then the participants scored the importance of each goal and their level of satisfaction with this activity. In the second part, structured questions are asked about comfort, satisfaction with the sitting position and skin damage.

44 people with paraplegic spinal cord injury participated in the telerehabilitation with an average age of 34.09 and a standard deviation of 8.19 and a control group with an average age of 35.50 and a standard deviation of 8.70. The average of all scores in the participants of the intervention group had a significant difference (P<0.001). Also except for the score related to the level of comfort with sitting position in the wheelchair (P=0.1) and participation scores at home {(P=0.23) (P=0.11)}, the results of the comparison between the two groups were significant (P<0.001).

Based on the results, telerehabilitation was effective in the participation level of people with spinal cord injuries. Also, the results showed telerehabilitation had a significant impact on the patient's level of satisfaction with participation in their daily activities.