Effectiveness of telehealth in patients with spinal cord injury: A randomized controlled trial

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Background: Spinal cord injury (SCI) impacts every aspect of an injured individual’s life and necessitates ongoing surveillance to prevent subsequent complications. The tele-assessment of different diseases has demonstrated encouraging outcomes, and there is limited literature available about SCI. The present study aimed to document the effectiveness of telehealth on clinical outcomes, quality of life improvement, accessibility, psychological health, patient satisfaction and engagement, and caregiver perspective for patients with SCI. Methods: This study was carried out in a tertiary care centre. Fifty-six patients with acute SCI were randomized into group “S” (study group), who were followed with telehealth telephonically and through video conferencing plus in-person visits to the hospital at second and sixth months, and group “C” (control group) with in-person visit to the hospital only. Patients were assessed for clinical effectiveness (spinal cord independence measure-III, SCI Secondary Conditions Scale, and pressure ulcer scale for healing), psychological health (World Health Organization Quality of Life, patient health questionnaire, and purdue posttraumatic stress disorder), and patient and caregiver’s perspectives (patient satisfaction questionnaire-18, Patient Health Engagement Scale, and Caregiver Strain Index). The outcome measures were compared between the groups at baseline and follow-up using an independent sample t test at a significance level of P <0.05. Results: The mean age of patients was 38.00 ± 14.15 years with predominantly males. The telehealth group showed statistically significant (P = 0.042) improvement in total spinal cord independence measure III (SCI-III) score at 6-month follow-up. The SCI Secondary Conditions Scale, which shows the presence of secondary conditions, had a significantly lower score in the S group at the 6-month follow-up (P = 0.01). The World Health Organization Quality of Life domain 1 was higher in the S group at 6-month follow-up (P < 0.05). Of patients, 50% in the telehealth group were satisfied according to the Modified Reintegration to Normal Living Index scale at monthly follow-up compared with 28.6% in the control group (P < 0.05). The Patient Health Engagement Scale showed that 42.9% of patients reached the final stage of the eudaimonic project in the S group at 6-month follow-up compared with only 14.3% in the control group. Conclusions: Telehealth is an effective tool in the continued care of SCI patients post-hospital discharge. Our findings indicate that patients in the telehealth group report improved physical quality of life, enhanced quality of daily living, and decreased occurrence of medical complications. We suggest that multiple centres at the national level should collaborate to further evaluate telehealth. In the future, we should promote telehealth in the rehabilitation of SCI patients.

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