Doctor of Philosophy (PhD) in Physical Therapy
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College of Health Care Sciences - Physical Therapy Department
Cheryl J. Hill
Publication Date / Copyright Date
Nova Southeastern University
Robert W. Nithman. 2018. Use of a Telerehabilitation Delivery System for Fall Risk Screening. Doctoral dissertation. Nova Southeastern University. Retrieved from NSUWorks, College of Health Care Sciences - Physical Therapy Department. (77)
Problem: The Centers for Disease Control and Prevention indicates that falls are the “leading cause of injury death and the most common cause of nonfatal injuries and hospital admission for trauma among people ages 65 and older.”1 Falls can have significant economic consequences to the individual and payer sources. To address these consequences, telerehabilitation was hypothesized to be a suitable supplement for fall screening efforts. Several sources concluded that support for synchronous telerehab was underdeveloped in the literature. Purpose: The purpose of this study was to explore the acceptability, feasibility, reliability, and validity of telehealth-delivered fall screening among community-dwelling older adults. Procedures: This investigation implemented an experimental, quantitative, cross-sectional design employing both pretest-posttest control group and quasi-experimental static group comparisons using non-probability sampling. This study assembled a panel of experts to provide content validation for a survey tool developed to quantify an older adult’s behavioral intension to use and attitudes towards a telerehabilitation delivery system. Seven fall screening tools were investigated for agreement among remote and face-to-face raters, and for comparison with the face-to-face reference standard (Mini-BEST). Results: All three null hypotheses were rejected. Results indicate that a telerehabilitation delivery system is a reliable and valid method of screening and determining fall risk in community-dwelling older adults. This study produced a content validated, internally consistent survey instrument designed to determine attitudes and beliefs about telerehabilitation. An experimental design was able to demonstrate a positive significant change in 4 of 7 survey constructs among the intervention group after exposure to telerehabilitation as compared to post-test controls. Overall, no significant difference was calculated between face-to-face or telerehab raters, and both environments produced equivalency with scoring, fall risk classification, and ability to discern fallers from non-fallers. Results from the telerehab STEADI fall risk conclusions were calculated to be concurrently valid with the face-to-face reference standard screening tool, the Mini-BEST. Conclusions: This investigation expanded the array of remote healthcare delivery options for clinicians and clients. Further investigation in residential and community settings are recommended.
Applied sciences, Health and environmental sciences, Elderly falls, Fall prevention, Fall risk, Technology acceptance, Telehealth, Telerehabilitation