From bed-side to web-side, Advanced-Telemedicine platform for Spinal
Muscular Atrophy
Abstract
We aimed to assess feasibility, accuracy, satisfaction of an
advanced-telemedicine (A-TM) platform designed for remote physical
evaluation, especially focused on lung auscultation, in spinal muscular
atrophy (SMA) patients. Children affected by type 1 and 2 SMA, typically
present generalized weakness, scoliosis, chest deformities the leading
cause of progressive respiratory insufficiency and recurrent
hospitalization. Covid-19 stimulated efforts to adopt innovative digital
health solutions especially when caring for people living with
disabilities. Because of chest asymmetry and scoliosis, SMA patients are
not always the ideal candidates for telemedicine tools that have proved
to be useful in the general population. 23 children affected by SMA (15
type 1 and 8 type 2) with different degree of scoliosis and chest
asymmetry. Prospective study: We localized optimal thoracic auscultatory
landmarks with traditional stethoscope and lung ultrasound for each
child. Carers were trained to record complete lung auscultation
independently and share data with our physicians via A-TM platform.
After the first remote exam, carers videorecorded their experience
(satisfaction). Our physicians blindly rated the audio files shared via
A-TM which were compared to traditional auscultation findings for each
child. to assess. Overall feasibility and accuracy of carers-performed
remote physical evaluation. Our study showed that remotely performed
lung auscultation was possible in all type 1 and 2 SMA children but
adaptations to find optimal landmarks were needed in cases with
asymmetrical or rotated chest and trunk. A-TM tools may simplify access
to care, reduce logistic/economic burden for families, improve
communication, safety and disease management while limiting infection
exposure.