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Telerehabilitation is the method of using communication technologies to provide rehabilitation at a distance. Advancements in videoconferencing and networking technologies present opportunities to deliver rehabilitation services to patients at home, at school, in the workplace, and in the community. Speech-language treatment is an area of rehabilitation well suited for telerehabilitation. This article will review the technology for performing remote speech-language diagnosis and treatment for patients after stroke. Development of a telerehabilitation system incorporating computerized therapy tasks with a touchscreen interface is described. Such a system enhances off-the-shelf videoconferencing equipment and extends the potential utility and effectiveness of telerehabilitation sessions.

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This paper presents results from a study conducted at the Rehabilitation Engineering Research Center (RERC) on Telerehabilitation at the National Rehabilitation Hospital. The study was designed to measure performance by brain-injured subjects, with medical diagnoses of stroke or traumatic brain injury, on a standardized Speech-Language Pathology evaluation conducted in both face-to-face and videoconference-based telerehabilitation settings. The Story Retelling Procedure (SRP), which measures connected language production and comprehension of spoken narratives, was administered to each subject in both settings. The primary objectives of this study were to: (1) compare communication as measured by the SRP between experimental settings, and (2) determine if subject variables (such as age, education, technology experience or gender) had an effect on performance differences between settings. The rationale was that any difference in this aspect of performance must be identified and characterized before this mode of intervention can be used clinically. Across all subjects (n = 40), no significant difference (p > 0.05) was found between SRP performance measured in the two settings. Additionally, variables including age, education, technology experience, and gender did not significantly affect the difference between performance in the two settings. Overall, subjects reported a high level of acceptance of videoconferencing with 34 subjects responding "yes," 4 responding "no," and 2 responding "maybe" when asked if they would use videoconferencing again to talk to a clinician. Results of this study confirm the potential for SLP treatment using videoconferencing and indicate a need for continued research in the field.

Introduction: Outcomes research for speech language pathology (SLP) interventions for acute traumatic spinal cord injury (SCI) rehabilitation in the US is difficult because of the lack of a treatment classification system (taxonomy). Objective: To describe a taxonomy developed by speech language pathologists (SLPs) to examine the effects of SLP interventions on SCI rehabilitation outcomes. Methods: The SCIRehab study uses practice-based evidence, a rigorous observational methodology that examines treatment processes without specifying or requiring specific therapeutic interventions. Speech language pathology lead clinicians and researchers at 6 US SCI centers developed a detailed SLP taxonomy documentation process that is comprehensive of SLP interventions for patients with SCI. Results: The SLP taxonomy consists of 7 intervention categories that address deficits (speech production for patients with artificial airway, motor speech and voice, swallowing, cognitive-communication, and communication) and the associated exercises and tasks that patients perform. Time is recorded for each category, and supplementary information focuses on cueing needs and family involvement that helps to describe and guide intervention selection. The SCIRehab project is enrolling 1,500 patients with acute traumatic SCI at 6 inpatient rehabilitation facilities. Conclusions: Speech language pathology taxonomy information is being captured for the SCIRehab patients who are referred for SLP services; this may be the first attempt to document the many details of the SLP rehabilitation process for patients with SCI in the US.