
Dementia is a degenerative disease with various symptoms of problematic behavior such as cognitive impairment and dysfunction, including Alzheimer’s disease, peak disease, Parkinson’s disease and Huntington’s disease, and symptoms may be expressed due to vascular dementia, multiple sclerosis, brain tumors, and hydrocephalus.1 Dementia patients are unable to live independent daily lives as cognitive problems such as impulses, sleep disorders, hallucinations, and roaming continue, causing mental, emotional, and physical problems to caregivers of dementia patients due to great stress and burden of support.2,3
The number of caregivers for dementia patients in Korea amounts to 3.75 million, including spouses and children of dementia patients, and they play a very important role in supporting and caring for dementia patients.4 They suffer from high physical and psychological burdens and physical dysfunction such as depression, anxiety, and sleep disorders while caring for their patients, and as treatment time and intensity increase, emotional and cognitive burdens can cause overall health problems.5,6 According to the National Human Rights Commission of Korea, 45.9% of family members caring for dementia patients are worried about their own deteriorating health, 25.6% complain of emotional stress, and 20.8% have difficulty making a living, leading to the creation of a second patient.6
Caregivers of dementia patients use repetitive force in inappropriate positions for all activities related to the patient’s daily life, simple rehabilitation, and wheelchair-pushing tasks, complaining of chronic pain and sensory abnormalities in the neck and shoulders, waist, upper and lower limbs, nerves and muscles, and surrounding tissues.7,8 In addition, as fatigue accumulates and health conditions worsen, they give up on their own care, which negatively affects health management.9 Dementia patient caregivers often cannot visit hospitals for treatment or rehabilitation treatment due to their excessive role and fatigue, despite their deteriorating health conditions, because they cannot have personal time and freedom.2,10 These physical burdens and limitations make it realistically impossible for them to engage in various activities, such as exercise, to protect their exhausted bodies and minds and their health.11
Tele-rehabilitation refers to the use of various audiovisual devices such as remote video, text messaging, and virtual reality to receive physical therapy or rehabilitation services from a distance.12 Although tele-rehabilitation is criticized for its inconvenient accessibility to medical care, it has the advantage of being able to receive services without having to visit the hospital in person, eliminating time constraints through communication between patients and therapists, and reducing medical costs, making therapy efficient and convenient.13-15 Tele-rehabilitation has shown positive effects on patients with total knee replacement surgery who have difficulty walking and moving, stroke patients, and patients with quality of life problems due to knee pain.12,14,16 In this way, it is not only a method that can be suggested to those who cannot receive sufficient rehabilitation therapy at the hospital, but it can also be a method to solve the health management problems of dementia patients’ families or caregivers who do not have freedom in time and space.
Tele-rehabilitation therapy includes rehabilitation for dementia patients and rehabilitation for swallowing disorders for Parkinson’s disease patients, remote exercise programs for physical and mental health and social health for the elderly with disabilities, and rehabilitation for patients with musculoskeletal disorders.17-19 Although tele-rehabilitation services are being implemented and studied for various subjects, there is no research on caregivers who care for dementia patients. Therefore, this study aims to find out the awareness of dementia patients’ caregivers about tele-rehabilitation and the necessity of tele-rehabilitation therapy. This will serve as the basis for developing a tele-rehabilitation program for the health of dementia patients’ caregivers and will help improve the quality of life with dementia patients.
The participants in this study are those who care for dementia patients and those who directly care for dementia patients, such as relatives, caregivers, or nursing assistants. The survey was conducted through an online questionnaire from May 20 to June 20, 2024. The sample size was selected using G-power with effect size d: 0.15/err prob: 0.05/power (1-err prob): 0.85.
A total of 374 people were participated in the survey, and 348 were surveyed, excluding 26 with missing answers. Participants were anonymous, and consent was obtained for participation in the survey. In accordance with Article 13 (Protection of Confidentiality) of the statistics act, it was stated that the data would be used only for statistical analysis, and the contents would be strictly protected and would not be used for any other purpose than research. In addition, no personal information other than the survey required for the research was collected. A small gift certificate was given to the survey participants as a token of appreciation. The survey content included general characteristics of the participants and their perception of remote rehabilitation therapy. There were 22 questions in total, and it took about 5-10 minutes for each person to complete the survey.
The questionnaire used in this study was modified and supplemented from the survey on stress and satisfaction of primary care-givers who participated in self-help group of dementia safety centers by Kwon1, the survey on awareness and demand for tele-rehabilitation services targeting users of independent living centers for the disabled by Cha et al.20, and the survey on awareness of tele exercise rehabilitation according to the demographic characteristics of physical therapists by Park et al.21 The reliability of Kwon’s study1 was Cronbach’s α=0.913, Cha et al.’s Cronbach’s α=0.86920, and Park et al.’s Cronbarch’s α=0.903.21 The reliability of the questionnaire in this study was Cronbarch’s α=0.860.
SPSS 23.0 program (IBM Corp., Armonk, NY, USA) was used to analyze the data collected in this study. Frequency analysis was conducted to find out the general characteristics of the participants, and awareness of tele-rehabilitation therapy was conducted through frequency analysis and a 5-point Likert scale. A lower score on the 5-point scale indicates a lower awareness of tele-rehabilitation treatment or opposition to the item, while a higher score indicates a more positive or agreement. Pearson correlation analysis was conducted to find out the correlation between gender (Gen), age (Age), care time (CT), care period (CP), care location (CL), Caregiver rehabilitation experience (CRE), and Caregiver desired therapy area (CDTA) among the general characteristics of caregivers of dementia patients and awareness of tele-rehabilitation therapy. Momentum correlation measures the linear relationship between two variables, with a value closer to 1 indicating a positive relationship and a value closer to -1 indicating a negative relationship.
The results of the participant characteristics of this study showed that there were males 98 (28.2%) and females 250 (71.8%). The most common age group was 20-30s 47 (13.5%), 40-50s 281 (80.7%), and 60-70s 20 (5.7%). The most common educational background was middle school 7 (2.0%), high school 83 (23.9%), college 60 (17.2%), university 192 (55.2%), and graduate school or higher 6 (1.7%). The most common relationship with the dementia patient was spouse 14 (4.0%) and daughter 183 (53.6%). There were sons 85 (24.4%), daughters-in-law 40 (11.5%), and 3 sons-in-law and 3 relatives (0.9%). There were caregiver for the sick 7 (2.0%) and nursing care worker 13 (3.7%). The duration of care was most often all day for 27 (7.8%) and more than half a day (more than 12 hours) for 135 (38.8%). More than 2 hours was the second most common for 79 (22.7%) and more than 3 hours for 107 (30.7%). The duration of care was from one week to one month for 13 (3.7%), 3-6 months for 131 (37.6%), and more than one year was the second most common with 118 (33.9%). More than two years was 84 (24.1%). The place of care was home for 237 (68.1%), followed by nursing homes for 69 (19.8%), hospital (hospitalization) for 35 (10.1%), and dementia centers for 6 (91.7%). The severity of dementia patients’ symptoms was similar, with 30 (8.6%) having mild cognitive impairment, 134 (38.5%) having early stage dementia, and 139 (40.0%) having mild dementia. 45 (12.9%) had severe dementia. As to whether they experienced any pain while caring for a dementia patient, 295 (84.8%) answered ‘yes’, while 53 (15.2%) answered ‘no’. As to whether they received rehabilitation therapy at a hospital, 229 (65.8%) answered ‘yes’, while 119 (34.2%) answered ‘no’. The most painful part was the cervical spine (neck) with 60 (17.2%) and the shoulder with 147 (42.2%). The waist with 114 (32.8%), the knee with 24 (6.9%), and the ankle with 3 (0.9%). The most painful part was the cervical spine (neck) with 60 (17.2%) and the shoulder with 144 (41.42%). The waist with 117 (33.6%), the knee with 24 (6.9%), and the ankle with 3 (0.9%). The details are as follows (Table 1).
General characteristics of participants (n=348)
Contents | Characteristics | Participants (n) | % |
---|---|---|---|
Gender | Male | 98 | 28.2 |
Female | 250 | 71.8 | |
Age | 20-30s | 47 | 13.5 |
40-50s | 281 | 80.7 | |
60-70s | 20 | 5.7 | |
80s over | - | - | |
Final education | Middle school | 7 | 2.0 |
High school | 83 | 23.9 | |
College | 60 | 17.2 | |
University | 192 | 55.2 | |
Graduate school or higher | 6 | 1.7 | |
Relationship with dementia patient | Spouse | 14 | 4.0 |
Daughter | 183 | 53.6 | |
Son | 85 | 24.4 | |
Daughter-in-law | 40 | 11.5 | |
Son-in-law | 3 | 0.9 | |
Relative | 3 | 0.9 | |
Caregiver for the sick | 7 | 2.0 | |
Nursing care worker | 13 | 3.7 | |
Time of patient care | All day | 27 | 7.8 |
More than half a day (12 hours or more) | 135 | 38.8 | |
More than 2 hours | 79 | 22.7 | |
More than 3 hours | 107 | 30.7 | |
Period of patient care | A week to a month or more | 13 | 3.7 |
3 months to 6 months or more | 131 | 37.6 | |
A year or more | 118 | 33.9 | |
2 years or more | 84 | 24.1 | |
Place to care for patient | Home | 237 | 68.1 |
Nursing home | 69 | 19.8 | |
Hospital (hospitalization) | 35 | 10.1 | |
Dementia center | 6 | 1.7 | |
Patient's degree of dementia | Mild cognitive impairment | 30 | 8.6 |
Early stage dementia | 134 | 38.5 | |
Mild dementia | 139 | 40.0 | |
Severe dementia | 45 | 12.9 | |
Areas of pain that occur while caring for a dementia patient | Yes | 295 | 84.8 |
No | 53 | 15.2 | |
Experience receiving rehabilitation therapy | Yes | 229 | 65.8 |
No | 119 | 34.2 | |
Areas you currently the most painful part | Cervical spine (neck) | 60 | 17.2 |
Shoulder | 147 | 42.2 | |
Waist | 114 | 32.8 | |
Knee | 24 | 6.9 | |
Ankle | 3 | 0.9 | |
Areas you currently wish to receive therapy | Cervical spine (neck) | 60 | 17.2 |
Shoulder | 144 | 41.4 | |
Waist | 117 | 33.6 | |
Knee | 24 | 6.9 | |
Ankle | 3 | 0.9 |
The results of the awareness of remote rehabilitation therapy in this study were as follows: No. 1 “Do you know about tele-rehabilitation therapy?” 27 (7.8%) answered ‘very much’ 172 (49.4%) answered ‘somewhat’ 79 (22.7%) answered ‘average’ 58 (16.7%) answered ‘disagree’ 12 (3.4%) answered ‘not at all’. The mean and standard deviation were 2.59±0.97. No. 2 “Do you think it is possible to receive rehabilitation therapy remotely?” 81 (23.3%) answered ‘very much’ 145 (41.7%) answered ‘somewhat’ 79 (22.7%) answered ‘average’ 36 (10.3%) answered ‘disagree’ 7 (2.0%) answered ‘not at all’. The mean and standard deviation were 2.29±0.99. No. 3 “If you could receive rehabilitation therapy remotely, would you receive it?” 97 (27.9%) answered ‘very much’ 164 (47.1%) answered ‘somewhat’ 62 (17.8%) answered ‘average’ 21 (6.0%) answered ‘disagree’ 4 (1.1%) answered ‘not at all’. The mean and standard deviation were 2.05±0.89. No. 4 “Do you think tele-exercise rehabilitation would benefit you?” 96 (27.6%) answered ‘very much’ 158 (45.4%) answered ‘somewhat’ 60 (17.2%) answered ‘average’ 25 (7.2%) answered ‘disagree’ 9 (2.6%) answered ‘not at all’. The mean and standard deviation were 2.12±0.97. No. 5 “If you are to receive tele-rehabilitation therapy, how many times a week do you think is best?” 63 (18.1%) answered ‘once a week’ 217 (62.4%) answered ‘2-3 times a week’ 55 (15.8%) answered ‘4-5 times a week’ 7 (2.0%) answered ‘6 times’ answered ‘all week’ 6 (1.7%). The mean and standard deviation were 2.07±0.75. No. 6 “Do you think that Rehabilitation therapy remotely can help you with your daily living activities?” 71 (20.4%) answered ‘very much’ 183 (52.6%) answered ‘somewhat’ 67 (19.3%) answered ‘average’ 23 (6.6%) answered ‘disagree’ 4 (1.1%) answered ‘not at all’. The mean and standard deviation were 2.16±0.86. No. 7 “Do you think it would be efficient to perform exercise rehabilitation remotely?” 91 (26.1%) answered ‘very much’ 154 (44.3%) answered ‘somewhat’ 78 (22.4%) answered ‘average’ 21 (6.0%) answered ‘disagree’ and 4 (1.1%) answered ‘not at all’. The mean and standard deviation were 2.12±0.90. No. 8 “Do you think space can be utilized efficiently when performing exercise rehabilitation remotely?” 91 (26.1%) answered ‘very much’ 157 (45.1%) answered ‘somewhat’ 72 (20.7%) answered ‘average’ 18 (15.2%) answered ‘disagree’ 10 (2.9%) answered ‘not at all so’. The mean and standard deviation were 2.14±0.95. No. 9 “Do you think communication between physical therapists and patients will be good when performing tele-exercise rehabilitation?” 78 (22.4%) answered ‘very much’ 165 (47.4%) answered ‘somewhat’ 84 (24.1%) answered ‘average’ 17 (4.9%) answered ‘disagree’ 4 (1.1%) answered ‘not at all’. The mean and standard deviation were 2.15±0.86. No. 10 “Do you think you will be able to help dementia patients after receiving tele-rehabilitation treatment?” 84 (24.1%) answered ‘very much’ 175 (50.3%) answered ‘somewhat’ 70 (20.1%) answered ‘average’ 17 (4.9%) answered ‘disagree’ and 2 (0.6%) answered ‘not at all’. The mean and standard deviation were 2.07±0.82. Details are as follows (Table 2).
Awareness of telerehabilitation treatment (n=348)
Contents | Participants (n) | % | M±SD | |
---|---|---|---|---|
① Do you know about tele-rehabilitation therapy? | Very much | 27 | 7.8 | |
Somewhat | 172 | 49.4 | ||
Average | 79 | 22.7 | 2.59±0.97 | |
Disagree | 58 | 16.7 | ||
Not at all | 12 | 3.4 | ||
② Do you think it is possible to receive rehabilitation therapy remotely? | Very much | 81 | 23.3 | |
Somewhat | 145 | 41.7 | ||
Average | 79 | 22.7 | 2.29±0.99 | |
Disagree | 36 | 10.3 | ||
Not at all | 7 | 2.0 | ||
③ If you could receive rehabilitation therapy remotely, would you receive it? | Very much | 97 | 27.9 | |
Somewhat | 164 | 47.1 | ||
Average | 62 | 17.8 | 2.05±0.89 | |
Disagree | 21 | 6.0 | ||
Not at all | 4 | 1.1 | ||
④ Do you think tele-exercise rehabilitation would benefit you? | Very much | 96 | 27.6 | |
Somewhat | 158 | 45.4 | ||
Average | 60 | 17.2 | 2.12±0.97 | |
Disagree | 25 | 7.2 | ||
Not at all | 9 | 2.6 | ||
⑤ If you are to receive tele-rehabilitation therapy, how many times a week do you think is best? | Once a week | 63 | 18.1 | |
2-3 times a week | 217 | 62.4 | ||
4-5 times a week | 55 | 15.8 | 2.07±0.75 | |
6 times | 7 | 2.0 | ||
All week | 6 | 1.7 | ||
⑥ Do you think that Rehabilitation therapy remotely can help you with your daily living activities? | Very much | 71 | 20.4 | |
Somewhat | 183 | 52.6 | ||
Average | 67 | 19.3 | 2.16±0.86 | |
Disagree | 23 | 6.6 | ||
Not at all | 4 | 1.1 | ||
⑦ Do you think it would be efficient to perform exercise rehabilitation remotely? | Very much | 91 | 26.1 | |
Somewhat | 154 | 44.3 | ||
Average | 78 | 22.4 | 2.12±0.90 | |
Disagree | 21 | 6.0 | ||
Not at all | 4 | 1.1 | ||
⑧ Do you think space can be utilized efficiently when performing exercise rehabilitation remotely? | Very much | 91 | 26.1 | |
Somewhat | 157 | 45.1 | ||
Average | 72 | 20.7 | 2.14±0.95 | |
Disagree | 18 | 5.2 | ||
Not at all | 10 | 2.9 | ||
⑨ Do you think communication between physical therapists and patients will be good when performing tele-exercise rehabilitation? | Very much | 78 | 22.4 | |
Somewhat | 165 | 47.4 | ||
Average | 84 | 24.1 | 2.15±0.86 | |
Disagree | 17 | 4.9 | ||
Not at all | 4 | 1.1 | ||
⑩ Do you think you will be able to help dementia patients after receiving tele-rehabilitation treatment? | Very much | 84 | 24.1 | |
Somewhat | 175 | 50.3 | ||
Average | 70 | 20.1 | 2.07±0.82 | |
Disagree | 17 | 4.9 | ||
Not at all | 2 | 0.6 |
M±SD: mean±standard deviation.
awareness of tele-rehabilitation therapy
The results of the correlation between participant characteristics and awareness of tele-rehabilitation therapy showed a negative correlation between gender and No. 2 (r=-0.144, p<0.01), No. 4 (r=-0.166, p<0.01), No. 6 (r=-0.140, p<0.01), No. 7 (r=-0.130, p<0.05), No. 8 (r=-0.159, p<0.01), No. 10 (r=-0.160, p<0.01). Age and No. 1 (r=0.150, p<0.01), No. 2 (r=0.134, p<0.05), No. 3 (r=0.205, p<0.01). A positive correlation was shown in No. 4 (r=0.192, p<0.01), No. 5 (r=0.193, p<0.01), No. 6 (r=0.187, p<0.01), and No. 10 (r=0.209, p<0.01), and a negative correlation was shown in No. 7 (r=-0.163, p<0.01). A negative correlation was shown between care time and No. 4 (r=-0.125, p<0.05), and between care period and No. 5 (r=-0.164, p<0.01), and a positive correlation was shown between care location and No. 2 (r=0.198, p<0.01) and No. 10 (r=0.142, p<0.01). Rehabilitation experience. A negative correlation was found in No. 6 (r=-0.116, p<0.05), No. 10 (r=-0.175, p<0.01). A positive correlation was found in the desired treatment area and No. 4 (r=0.127, p<0.05). No correlation was found in other questionnaires. Details are as follows (Table 3).
Correlation between participant characteristics and awareness of telerehabilitation therapy
Gen | Age | CT | CP | CL | CRE | CDTA | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Gen | 1 | ||||||||||||||||
Age | -0.053 | 1 | |||||||||||||||
CT | -0.138** | -0.084 | 1 | ||||||||||||||
CP | -0.046 | -0.030 | 0.025 | 1 | |||||||||||||
CL | -0.187** | -0.052 | 0.079 | 0.158** | 1 | ||||||||||||
CRE | 0.195** | -0.039 | 0.106* | -0.209** | -0.046 | 1 | |||||||||||
CDTA | -0.007 | 0.106* | 0.074 | 0.107* | 0.065 | -0.028 | 1 | ||||||||||
1 | 0.076 | 0.150** | 0.067 | -0.024 | -0.020 | 0.058 | 0.028 | 1 | |||||||||
2 | -0.144** | 0.134* | 0.028 | -0.039 | 0.198** | -0.043 | 0.091 | 0.441** | 1 | ||||||||
3 | -0.005 | 0.205** | -0.081 | -0.101 | 0.062 | -0.071 | 0.040 | 0.345** | 0.382** | 1 | |||||||
4 | -0.166** | 0.192** | -0.125* | -0.083 | 0.105 | -0.037 | 0.127* | 0.307** | 0.528** | 0.348** | 1 | ||||||
5 | -0.078 | 0.193** | -0.009 | -0.164** | 0.078 | -0.082 | 0.044 | 0.078 | 0.279** | 0.263** | 0.289** | 1 | |||||
6 | -0.140** | 0.187** | -0.063 | -0.080 | 0.048 | -0.116* | 0.078 | 0.274** | 0.470** | 0.456** | 0.546** | 0.209** | 1 | ||||
7 | -0.130* | -0.163** | -0.079 | -0.060 | 0.058 | 0.007 | 0.050 | 0.345** | 0.520** | 0.419** | 0.433** | 0.258** | 0.324** | 1 | |||
8 | -0.159** | 0.074 | 0.001 | -0.081 | 0.040 | 0.038 | 0.570 | 0.296** | 0.456** | 0.344** | 0.469** | 0.238** | 0.491** | 0.394** | 1 | ||
9 | -0.077 | 0.101 | -0.136* | -0.074 | 0.025 | -0.034 | 0.019 | 0.295** | 0.391** | 0.411** | 0.413** | 0.271** | 0.411** | 0.487** | 0.342** | 1 | |
10 | -0.160** | 0.209** | -0.057 | -0.071 | 0.142** | -0.175** | 0.054 | 0.243** | 0.487** | 0.445** | 0.501** | 0.309** | 0.513** | 0.442** | 0.474** | 0.380** | 1 |
Gender: Gen, Care time: CT, Care period: CP, Care location: CL, Caregiver rehabilitation experience: CRE, Caregiver desired therapy area: CDT. **p<0.01, *p<0.05.
This study aimed to investigate the perception of remote rehabilitation among primary caregivers for patients with dementia. The general characteristics of the participants were similar to those in the study by Kwon and Hong (Son)22, and the rate of musculoskeletal disorders surveyed by the Korea Occupational Safety and Health Research Institute was in the order of waist, shoulder, arm, and knee.7
In all the surveys except No. 5 of the survey on awareness of tele-rehabilitation, caregivers of dementia patients said that tele-rehabilitation therapy is possible and that tele-rehabilitation will help with the painful areas. They also responded positively that the utilization of therapy space and communication with physical therapists will be smooth and that it can help dementia patients. In a study conducted in Denmark, a positive response was shown to tele-rehabilitation therapy when tele-rehabilitation methods were presented through video conferencing, telephone support, web-based platforms, and mobile applications.15 However, the overall average awareness in this study was low at 2 points. This result is similar to the result of the study by Jung et al.23, where the awareness of remote physical therapy among middle-aged and elderly people in their 50s or older was low at 2.23 points. This is thought to be because they are not familiar with tele-rehabilitation and do not have much experience. Regarding No. 5, “If you are to receive tele-rehabilitation treatment, how many times a week do you think is best?”, the most common response was 2-3 times a week. Users of the Independent Living Center for the Disabled said that they wanted to use the remote rehabilitation service 3-4 times a week.20 This difference may have occurred because the situations and conditions of those with disabilities and caregivers of dementia patients are different. According to the Basic Analysis Report (II) of the Korean Medical Panel, the biggest reason for not receiving therapy or testing despite needing to do so was ‘difficulty making time’, accounting for the largest proportion.24 This is likely because they thought that the most appropriate number of times to devote time to hospital therapy while caring for a patient was 2 or 3 times. Regarding the correlation between the characteristics of the participants and their awareness of tele-rehabilitation therapy, there was a negative correlation between gender and No. 2, 4, 6, 7, 8, and 10, age and No. 7, care time and No. 4, care period and No. 5, and rehabilitation experience and No. 6 and 10. The level of awareness of tele-rehabilitation therapy was lower in older age groups.20 According to a study by Park et al.25, caregivers were mostly middle-aged or elderly people in their 40-50s, and they said that there were limitations in accessibility and convenience when using mobile apps, etc., and that they should be easily accessible in the care field. This is because the older the participants, the longer the period and time of care, and the less experience they have with rehabilitation therapy, the more difficult it is to access and conveniently collect information about tele-rehabilitation, which leads to less interest in tele-rehabilitation therapy. Age and No. 1, 2, 3, 4, 5, 6, and 10, location and No. 2 and 10, and desired therapy area and No. 4 were positively correlated. According to a study by Cha et al.20, it was reported that the burden of travel time for caregivers to receive therapy would decrease if they received tele-rehabilitation services. This is because the older the participants were, the more they felt the need for therapy, and they would have sympathized with the efficiency of space because they could not easily go out to receive therapy while leaving the dementia patient behind. In addition, they would have thought that if the pain was relieved by receiving therapy for the painful area, it would be more helpful to the dementia patient.
Tele-rehabilitation therapy uses information and communication technology to provide rehabilitation services in a living environment rather than a hospital or therapy room, and allows for various evaluations and therapy by selecting a treatment that suits the individual.26 In addition, it can induce behavioral changes through real-time feedback at a convenient time without having to meet the therapist face-to-face.13 According to a study by Turolla et al.27, musculoskeletal therapy through tele-rehabilitation was very effective. In addition, it was effective for balance and walking function, and the range of joint motion and postural alignment of elderly people with round shoulders were improved.13 In this way, tele-rehabilitation therapy may be a suitable therapy method for patients in special environments who cannot receive sufficient therapy due to time and movement constraints, such as patients who have difficulty walking or moving, dementia patients, and caregivers.
However, dementia patient caregivers often cannot obtain help or information due to low awareness of remote rehabilitation therapy despite needing health care. Therefore, in order to provide a lot of information and help, dementia patient support centers or local governments should promote the distribution of materials and notification services.
In addition, policy measures should be sought to ensure that dementia patient caregivers do not have difficulties in linking with hospitals and renting or purchasing machines or equipment for remote rehabilitation. The limitations of this study include that the target group of participants was wide and most participants had no experience with tele-rehabilitation, making it difficult to obtain specific information. In addition, there were few previous studies on caregivers of dementia patients and tele-rehabilitation, making comparative analysis difficult.
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