The use of information and communication technology in healthcare to improve participation in everyday life: a scoping review

Figures & data

Figure 1. PRISMA flowchart of search and inclusion.

Table 1. Main characteristics and outcomes of the included studies.

First author, year – country	Design; participants; age; sex	Diagnosis	Main outcome – technology	Aim; key findings
Boehm [39], 2015 – USA	Pilot study Case study; N = 1; 70 years old; male	Stroke	Occupational performance and satisfaction & fatigue impact – Telephone	To pilot test the Managing Fatigue course to provide for the occupational needs of people with post-stroke fatigue; The COPM average performance score improved by 0.4 points, and the average satisfaction score improved by 0.8 points. These scores are well below meaningful change on the COPM. Fatigue scores lowered from 47 to 13 out of 160 on the Fatigue Impact Scale.
Chumbler [40], 2012 – USA	RCT; Intervention Group: N = 25; $\overline{x}$age 67.1 (9.5); 24 males, 1 female Control Group: N = 23; $\overline{x}$age 67.7 (10.0); 23 males	Stroke	Basic activities of daily living – Video-conference & Telephone	To study the effect of a multifaceted stroke telerehabilitation intervention using functionally based exercises and adaptive strategies, on physical function, and secondarily on disability; The STeleR (= Stroke TeleRehabilitation) intervention did improve participants’ ability to perform life tasks and decreased the limitation in activities at home. The difference was not significant between groups as measured by the Late-Life Function and Disability Instrument Function total score.
Forducey [37], 2012 – USA	Pilot study RCT; Intervention Group N = 4, Control Group N = 5; $\overline{x}$age 60 (47-75); sex not reported	Stroke	Independence – Video-conference	To compare the effects of home-based telehealth versus standard home care services on changes in emotional and physical health status for older persons with stroke; Both telerehabilitation and control groups showed statistically significant improvement in ADL. No significant differences in improvement were found between groups, however the number of visits required were significantly lower in the telehealth based treatment.
Hermann [36], 2010 – USA	Case study; N = 1; 62 years old; male	Stroke	Occupational performance and satisfaction – Video-conference	The primary study objective was to examine the efficacy of this inexpensive, remotely based rehabilitative approach in a stroke patient exhibiting stable, affected, upper-extremity impairment; The COPM satisfaction significantly increased for all five of the COPM tasks by 4 to 6 points. The participant showed notable performance changes in one COPM task.
Jones [34], 2016 – Australia	Single group; N = 24; $\overline{x}$age 51.13 (16.52); 10 males, 14 females	Stroke (N = 20) Traumatic brain injury (N = 4)	Participation – Telephone & email	The primary aim of this study was to examine the feasibility and acceptability of a remotely delivered self-management program, the myMoves Program; As measured by the modified Reintegration to Normal Living Index there was a statistically significant improvement in participation immediately after the program, with an average increase of 2.8 points. The improvement did not remain significant at the 3 month follow-up, although the mean scores for all participation measures remained higher than those at baseline.
Linder [38], 2015 – USA	RCT; Intervention Group N = 51; $\overline{x}$age 59.4 (13.6); 31 males, 20 females. Control Group N = 48; $\overline{x}$age 55.5 (12.6); 33 males, 15 females	Stroke	ADL & meaningful activities – Telephone & Website	To report the nonmotor outcomes of two home-based rehabilitation interventions: (1) a home exercise program and (2) robot-assisted therapy + home exercise program; The intervention group did not have significantly better results compared to the control group. Participants in both groups improved significantly on the Stroke Impact Scale domain scores except for ‘memory’ and ‘mood’.
Makai [43], 2014 – The Netherlands	RCT; Intervention Group N = 179; $\overline{x}$age 81.69 (5.38); 62 males, 117 females. Control Group N = 270; $\overline{x}$age 81.32 (5.72); 103 males, 167 females	Frail elderly	ADL, instrumental ADL & social activity – Online health community	To investigate the effectiveness of an online health community intervention for older people with frailty aimed at facilitating multidisciplinary communication; No significant improvement on ADL, instrumental ADL, or social activity were observed as measured by the Katz ADL, Katz-15 and the Short Form-36.
Mayo [42], 2008 – Canada	RCT; Intervention Group N = 96; $\overline{x}$age 70 (14.5); 64 males, 32 females. Control Group N = 94; $\overline{x}$age 72 (12.95); 52 males, 42 females	Stroke	ADL & participation – Telephone	To determine whether persons newly discharged into the community following an acute stroke would report better health related quality of life and have fewer emergency room visits and non-elective hospitalizations if assigned to a stroke case manager in comparison to those receiving usual procedures for post-hospital care; The nursing case management intervention did not have significant effects on any of the health or function-related outcomes. Only a small, non-significant, improvement was found on the reintegration to normal living index in both groups at follow-up.
Ng [35], 2013 – Canada	Pilot study Case studies; N = 3; age 47, 34 & 55; male	Traumatic brain injury	Occupational performance and satisfaction & participation – Video-conference	To explore the feasibility of administering the CO-OP approach via a telerehabilitation format. And to examine if the CO-OP approach in its telerehabilitation format can promote community integration and help manage the influence of executive dysfunction in everyday life for adults with traumatic brain injury;Significant improvements in participation were reported by 2 patients and 2 significant others. The other patient also improved on the participation measure Mayo-Portland Adaptability Inventory-4, Participation Index. The CO-OP approach via telerehabilitation was found to be feasible and to adhere to the seven key features. Results on the COPM showed that a greater number of trained and untrained goals improved at follow-up compared to post-intervention.
Nguyen [41], 2008 – USA	Pilot study RCT; Intervention Group N = 20; $\overline{x}$age 70.9 (8.6); 12 males, 8 females. Control Group N = 19; $\overline{x}$age 68 (8.3); 10 males, 9 females	Chronic obstructive pulmonary disease	ADL – Web-based application	To compare the efficacy of the internet-based dyspnea self-management program with a face-to-face dyspnea self-management program on the primary outcome of dyspnea with ADL in patients with moderate to severe Chronic obstructive pulmonary disease over a longer period using a randomized design; Participants in both programs showed similar clinically meaningful changes in dyspnea with ADL from baseline to 3 months and sustained these improvements for the most part at 6 months. The sustained improvements in dyspnea with ADL reflect the specificity of the intervention.
Pilutti [33], 2014 – USA	RCT; Intervention Group N = 41; $\overline{x}$age 48.4 (9.1); 11 males, 30 females. Control Group N = 41; $\overline{x}$age 49.5 (9.2); 9 males, 32 females	Multiple sclerosis	Physical activity – Website & Videoconference	To examine the efficacy of an internet-delivered behavioral intervention for improving secondary outcomes of fatigue, depression, anxiety, pain, sleep quality, and health related quality of life. The secondary aim is to replicate previous results regarding change in physical activity using self-reported and objectively measures outcomes;Participants in the intervention group participated in significantly more self-reported physical activity compared with controls post-trial. Lifestyle physical activity includes leisure, occupational, and household activities as a part of everyday life.

ADL: Activities of Daily Living; COPM: Canadian Occupational Performance Measure; CO-OP: Cognitive Orientation to daily Occupational Performance.

Boehm N, Muehlberg H, Stube JE. Managing poststroke fatigue using telehealth: a case report. Am J Occup Ther. 2015;69(6):1–7.

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Chumbler NR, Quigley P, Li X, et al. Effects of telerehabilitation on physical function and disability for stroke patients: a randomized, controlled trial. Stroke. 2012;43(8):2168–2174.

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Forducey PG, Glueckauf RL, Bergquist T, et al. Telehealth for persons with severe functional disabilities and their caregivers: facilitating self-care management in the home setting. Psychol Serv. 2012;9(2):18.

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Hermann VH, Herzog M, Jordan R, et al. Telerehabilitation and electrical stimulation: an occupation-based, client-centered stroke intervention. Am J Occup Ther. 2010;64(1):73-81.

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Jones TM, Dear BF, Hush JM, et al. myMoves program: feasibility and acceptability study of a remotely delivered self-management program for increasing physical activity among adults with acquired brain injury living in the community. Phys Ther. 2016;96(12).

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Linder S, Rosenfeldt A, Bay R, et al. Improving quality of life and depression after stroke through telerehabilitation. Am J Occup Ther. 2015;69(2):1–10.

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Makai P, Perry M, Robben SHM, et al. Evaluation of an eHealth intervention in chronic care for frail older people: why adherence is the first target. J Med Internet Res. 2014;16(6):e156.

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Mayo NE, Nadeau L, Ahmed S, et al. Bridging the gap: the effectiveness of teaming a stroke coordinator with patient's personal physician on the outcome of stroke. Age Ageing. 2008;37(7):32–38.

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Ng EMW, Polatajko HJ, Marziali E, et al. Telerehabilitation for addressing executive dysfunction after traumatic brain injury. Brain Inj. 2013;27(5):548–564.

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Nguyen H, Donesky-Cuenco D, Wolpin S, et al. Randomized controlled trial of an internet-based versus face-to-face dyspnea self-management program for patients with chronic obstructive pulmonary disease: pilot study. J Med Internet Res. 2008;10(2):e9.

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Pilutti LA, Dlugonski D, Sandroff BM, et al. Randomized controlled trial of a behavioral intervention targeting symptoms and physical activity in multiple sclerosis. Mult Scler. 2014;20(5).

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