Telerehabilitation

Commonly used modalities include webcams, videoconferencing, phone lines, videophones and webpages containing rich Internet applications.

If the research shows that tele-assessments and tele-therapy are equivalent to clinical encounters, it is more likely that insurers and Medicare will extend coverage to certain telerehabilitation services as was the case during the pandemic (see also Occupational Therapy).

The clinical services provided by speech-language pathology readily lend themselves to telerehabilitation applications due to the emphasis on auditory and visual communicative interaction between the client and the clinician.

Using a high speed videoconferencing system link, Sicotte, Lehoux, Fortier-Blanc and Leblanc (2003) assessed and treated six children and adolescents with a positive reduction in the frequency of dysfluency that was maintained six months later.

In addition, a videoconferencing platform has been used successfully to provide follow-up treatment to an adult who had previously received intensive therapy (Kully, 200).

A recent Australian pilot study has investigated the feasibility of an Internet-based assessment of speech disorder in six children (Waite, Cahill, Theodoros, Russell, Busuttin, in press).

Lalor, Brown and Cranfield (2000) were able to obtain an initial assessment of the nature and extent of swallowing dysfunction in an adult via a videoconferencing link although a more complete evaluation was restricted due to the inability to physically determine the degree of laryngeal movement.

A more sophisticated telerehabilitation application for the assessment of swallowing was developed by Perlman and Witthawaskul (2002) who described the use of real-time videofluoroscopic examination via the Internet.

[29][30][31][32][33][34][35][36][37][38][39][40][41][42] There continues to be a need for ongoing research to develop and validate the use of telerehabilitation applications in speech-language pathology in a greater number and variety of adult and paediatric communication and swallowing disorders.

Occupational Therapy Practitioners (OTP), work with people across the lifespan in order to facilitate independence, establish or rehabilitate roles, habits and routines.

In motor training exercises, a provider guides a patient through performing different motions and activities in order to regain strength and function.

Motor training through telerehabilitation has consistently been shown to produce equivalent functional outcomes compared with in-person therapy.

Goal setting telerehabilitation has been shown to produce increased patient satisfaction and improvement in activities of daily living compared with a control group receiving no therapy.

Robotic telerehabilitation studies have shown patient improvement from baseline but equivalent functional outcomes compared with motor training exercises.

[51] Addressing this technological gap could help showcase the potential impact of telerehabilitation on cardiac rehabilitation accessibility and participation as well as person-centered, health, and economic outcomes.

[51] In a 2018 systematic review of 15 studies it was found that there were no significant differences in given tests and measures between telerehabilitation and control groups when it came to post stroke care.

Rural telemedicine in the United States is heavily subsidized through federal agency grants for telecommunications operations, starting in the 1990s.

This appears to be changing, as in response to the health access challenges during the COVID-19 pandemic, new opportunities for telehealth have emerged within many healthcare networks, including for rehabilitation services.

[53] The State of Science Conference held in 2002 convened most of military and civilian clinicians, engineers, and government officials interested in using telecommunications as a modality for rehabilitation assessment and therapy; a summary is provided in Rosen, Winters & Lauderdale (2002).

The 21-chapter book Telerehabilitation (2013)[55] provides a good summary of the work of these RERCs and various colleagues, covering a wide variety of tele-applications in various rehabilitation fields plus policy issues.

In 2001, O. Bracy, a neuropsychologist, introduced the first web based, rich internet application, for the telerehabilitation presentation of cognitive rehabilitation therapy.

Rehabilitation researchers need to conduct many more controlled experiments and present the evidence to clinicians (and payers) that telerehabilitation is clinically effective.

These employ a suite of interactive goal-directed tasks, tunable by a therapist, that make use of simple robots or devices using game ports (e.g., Feng and Winters, 2007[56]).