Evaluation of a technology suported rehabilitation program

In 2025, 35% of the Dutch population is above 55 years. Because the risk of a
chronic disease increases with age, an increase in the number of patients with
chronic disorders is expected. Another negative side effect of aging is a
decrease of the work population and the decreasing population of healthcare
professionals: resulting in an imbalance of the care demand and care supply.
Technological developments and ICT give the opportunity to comply with the
growing demands of care. Telemedicine interventions can shorten the stay at a
hospital or rehabilitation centre and can extend the care at home by remote
monitoring and remotely supervised treatment under the continuous supervision
of a health care professional. In the treatment of chronic diseases, for
example COPD/ASTMA and chronic pain, an increase of the physical condition of
patients is important. Patients participate in an exercise program at a clinic
supervised by a therapist. To increase the intensity of the treatment the
therapist can assign home exercises. These by paper supported exercise programs
are effective, but low adherence to there program is problematic. The adherence
of a home-based exercise program can increase by a more detailed description of
the exercises or to support the exercises with images or video and supervision
of the therapist during training at home. This can be achieved by a new
telemedicine application; a video-based teletreatment service with a database
of exercises and different modalities to contact patient and professional. This
computer supported exercise program will be implemented in rehabilitation
centre *het Roessingh* and will be combined with existing programs of COPD and
chronic pain patients.

The objective of the present study is to investigate the user satisfaction,
clinical effectiveness, and economic outcomes of the computer supported
exercise program.

For this study is chosen for an observational prospective cohort design. The
study comprises an observation of the patients receiving the traditional group
rehabilitation program at *Het Roessingh* (control group and historic cohort)
and the patients receiving the group rehabilitation program at *Het Roessingh*
extended with the computer supported exercise program (intervention group).

The computer supported exercises program is estimated to have minimal risk as
patients are trained in the exercises presented during the treatment and
learned to recognize their own boundaries. The burden to the patients exists of
filling in questionnaires and investing time to learn to operate the computer
supported exercise program. Potential risks and burden outweigh the potential
benefit patients receive, as they have the opportunity to receive detailed
information on what and how to execute exercises during their treatment.