Remote delivery of a standardized educational protocol for self-management of chronic swelling of the lower limbs in individuals with limited mobility
Bibliographic record
Abstract
The purpose of this study was to develop and evaluate the remote delivery of a standardized self-management protocol for chronic swelling of the lower limbs, termed Telerehabilitation to Empower You to Manage and Prevent Swelling (TR-PUMPS). This protocol was a component of a clinical trial designed to evaluate an in-home self-management program for chronic lower limb swelling in people with limited mobility that utilized TR to provide real time face-to face interactive educational and assessment sessions over a six week period. Developed as a series of videos, the protocol was designed to encompass 10 learning goals for self-management of chronic swelling/lymphedema. Content validity was determined by eight certified lymphedema therapists. The mean score for the videos was 4.5 ± 0.35 (Likert scale of 5 = strongly agree to 1 = strongly disagree). The readability level of 5th grade and superior suitability rating using the Suitability Assessment of Materials indicated materials were appropriate for various levels of health literacy in the study population. TR-PUMPS was implemented utilizing the Versatile and Integrated System for Telerehabilitation (VISYTER) software platform, a secure system that provides the ability for real-time teleconferencing. Evaluation of the subjects’ post intervention Competency in Self Care and Self-Management (CSCSM) of their chronic swelling resulted in a mean score of 94% + 4%. Inter-rater reliability of the CSCSM was high. The Intraclass Correlation Coefficient (ICC) for single measures was .913 with a 95% confidence interval of .913 - .980 (p = .000). ICC of average measures was .979 with a 95% confidence interval of .955 - .990 (p = .000). Self-identified performance goals measured by the Canadian Occupation Performance Measurement showed significant improvement post intervention (p = .008) and exceeded the minimal importance difference. There was no significant change in the subjects’ self-efficacy in management of their chronic swelling scores (p = .065). The subjects’ perceived usability of the remote delivery of TR-PUMPS was high with a mean score of 6.4 + 0.65 (Likert scale of 1 = disagree to 7 = agree). These results support TR-PUMPS as a viable method for providing a home-based self-management program for chronic swelling.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.016 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".