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Russian Remote Rehabilitation Technology will be Presented toDoctors of Asia and Europe

The Eurasian Orthopedic Forum will feature a number of workshops presenting leading edge practices in various areas of orthopedic traumatology. One of the workshops will concern remote-control rehabilitation. Prof. Konstantin Lyadov, Member of the Russian Academy of Sciences, Director of the Medsi Group Treatment Cluster, Head of the Research Team that developed this Russian innovation.

– Konstantin, why did you decide to develop this remote rehabilitation technology?

– The need was long overdue. Traumatologists and orthopedists have taken hold of ever increasing number of effective surgery techniques using cutting-edge technologies. However, we need to ensure that results are retained and physical/psychological recovery is taken care of postoperatively. The issue goes full-blown when the patient gets discharged, but cannot visit rehabilitation center because of the mobility limitations. Furthermore, not every center can boast qualified professional rehabilitation staff. The idea that patients can do rehabilitation exercises at home on their own is wrong.

– Please, tell us about the organization of remote rehabilitation?

– We named the technology remote-control rehabilitation, as it is based on continuous online control of the process by an instructor. To begin with, we use special routine to select patients. After that, a medical professional and medical technicians come to the patient’s house to install special medical equipment and everything for Internet video conference calls. They instruct the patient and patient’s relatives on the rehabilitation process. We design a 21-day program and schedule the time when the patient and the instructor meet online. The instructor makes the patient feel constant support, as the latter can always ask any question that is bothering him or her, and the instructor will refer the issue to the respective specialist (a clinical psychologist, speech therapist, neurologist, endocrinologist, physiotherapist, etc.) to discuss results and adjust the physical activity level. After the rehabilitation period is over, a group of medical professionals estimate the obtained results based on an international scale. In addition, they visit the patient at home on the last day of rehab to examine and estimate his/her condition, which is followed by equipment removal.

– What group of patients is this method intended for?

– It is intended for a wide range of motor and cognitive disorders. We used it to help patients after strokes and arthroplasty, severe brain and spinal cord damage, complex hip/upper limb/shoulder surgeries. Using this method, we cut in-patient care costs keeping the care quality unaffected and making the rehabilitation more comfortable for the patient, as it takes place at home. According to our estimates, 2-week-long rehab for the second stage in Russia requires 44 to 48 thousand rubles, while the remote rehab course takes only 22 to 24 thousand rubles. Remote control makes rehab available for many more patients, saves time, funds and other resources that can be, thus, allocated to the patients with the most severe cases needing second-stage in-patient rehabilitation. On the other hand, the technology may be used in surgical, gerontological centers, sanatoriums, nursing homes for the elderly, as well.

– Are there any similar technologies?

– No, it’s unique for Russia and has no rival in the world. We made our first international presentation of the technology two years ago, during a conference in Glasgow, and our foreign colleagues doubted its economic feasibility suggesting remote instructor’s work will be very expensive to organize. However, we proved social, clinical and financial efficiency of the technology. Development of all the methodological solutions is complete. We are sure that remote-control medical rehabilitation can successfully replace a certain part of in-patient services and are willing to share the experience. There is a number of medical areas, where Russia leads and the world follows. I hope, remote rehabilitation will become one of them. Moreover, innovative mobile equipment was designed by Russian engineers especially for this method.

– What innovative features does the equipment have?

– Ortorent Production Company cooperating with our research group offers a complex solution for remote-control rehabilitation. It also provides technical support of the project in Russia. Currently, there is a 15-machine series for mechanic therapy to restore motor function using special software. We plan to further expand the series. The machines are different from similar imported devices, as they are able to generate treatment regimen records giving feedback to both the patient and the doctor. It can be used for a patient of any height, even a child, and set to change physical activity level via remote control. The manufacturer is going to obtain CE certificate soon. Then, export to Europe will be allowed.

– How many Russian patients have already completed the remote rehab course?

– According to Ortorent, about 2,500 patient have completed the rehab using their equipment during 4 years of the project development. We started using the technology in Moscow in 2013. The project was supported by the Department of Labor and Social Protection of Moscow. In November 2016, we successfully introduced the remote rehab to the Reshma Medical Centre under the Federal Medical and Biological Agency of Russia in the Ivanovo Region. Since spring 2017, the doctors of Tatarstan have been mastering the method. Then, the doctors of the Perm Region joined them. The Tyumen Region and some other Russian entities expressed their interest, too. We are sure to see explosive development of remote rehabilitation in the next 2-3 years. Especially, since the Telemedicine Law was passed in Russia and the Russian Ministry of Health resolved to cover long-distance consultation services by compulsory medical insurance, as they saw its efficiency and now intend to provide us comprehensive support.

– Please, tell us what are the priorities of the research group in further development of the technology.

– Currently, we are working on maximizing its availability via use of mobile communications. Cooperating with the International Telecommunication Union, we have already designed a special solution and entered into a program testing agreement. It will allow using smartphones in addition to video conference and dedicated lines. Images from the smartphones will be transmitted to a computer screen, where the patient and the instructor will see each other. However, it requires a special QC system that would assure the process efficiency and safety.

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