ITALY.TELEREVALIDATIE.NL is a platform for promoting physical activity to patients with chronic diseases and older adults.
Adapted Physical Activity programs (APA) are group exercise programs, designed for individuals with chronic conditions, aimed at correcting sedentary lifestyle and hereinafter at the prevention or mitigation of frailty and disability. Despite the effectiveness of APA, the prescription and the adherence are very low. It is estimated that less then 11% of people above 65 years exercise regularly, and over 75 years this percentage shrink to 4%. The Guidelines of the American College of Sport Medicine propose a model for PA prescription based on the assessment of the APA needs of the patient and the FITT theory. The prescription per se increases the number of patients that start an PA program, nevertheless, issues are on the adoption of PA as a lifestyle. In recent years ICT has helped to develop tele-rehabilitation, allowing, patients to exercises at home through a web platform that also allows remote monitoring of the patient. We envisaged that such a solution would also be feasible for enforcing APA at home. Telerevalidatie.nl® is an ICT Platform that supports rehabilitation at home, allowing the patient to receive a personalized training program with tutorial videos and to track their training progress and physical activity during all day. The platform aims to improve adherence to cardiac and respiratory rehabilitation.
Evidence of success
The preliminary data provide the proof of evidence of the efficacy of a physical training program for older people that minimally impacts on their consolidated life habits. This intervention induced a significant improvement in physical performance and enhanced social interactions hence improving the quality of life. The efficacy of the adopted approach in improving the fitness of chronic patients was documented by the substantial increase in handgrip strength and in physical tests.
Potential for learning or transfer
The model of the Clinic for APA prescription is easily transferable and scalable, and the ICT solution is commercially available, at this point. Federico II University Hospital is currently revisiting the opportunity to expand the offer to other patients. In particular, a program for enforcing physical activity in oncological patients is in place, that can be potentiated by merging with the activity of the Clinic. Also, diabetes patients as well as neurological patients might find help from the enrolment in the Clinic. There is a program for the development of the clinic, that will go through the identification of larger ambulatory spaces for better assessment of the physical needs of the patients.
Given the fact that MD have a very low attitude to prescribe or refer patients to physical activity, Federico II University has also recently introduced a Master class for the Prescription of Physical Activity in Chronic Conditions to target the MD and Physical Trainers.