Telerehabilitation refers to the delivery of rehabilitation services via information and communication technologies. Clinically, this term encompasses a range of rehabilitation and habilitation services that include assessment, monitoring, prevention, intervention, supervision, education, consultation, and counseling. Telerehabilitation has the capacity to provide service across the lifespan and across a continuum of care. Just as the services and providers of telerehabilitation are broad, so are the points of service, which may include health care settings, clinics, homes, schools, or community-based worksites. This document was developed collaboratively by members of the Telerehabilitation SIG of the American Telemedicine Association, with input and guidance from other practitioners in the field, strategic stakeholders, and ATA staff. Its purpose is to inform and assist practitioners in providing effective and safe services that are based on client needs, current empirical evidence, and available technologies. Telerehabilitation professionals, in conjunction with professional associations and other organizations are encouraged to use this document as a template for developing discipline-specific standards, guidelines, and practice requirements.

Individuals with idiopathic Parkinson's disease (IPD) usually develop a speech disorder characterized by reduced loudness, hoarse and breathy voice, monotony of pitch, short rushes of speech, and imprecise consonants. The inability to effectively communicate impairs their ability to function in society and quality of life. A successful program developed to improve speech in these individuals is the Lee Silverman Voice Treatment (LSVT). A critical component of this treatment is intense daily therapy for 4 weeks, a regimen that is difficult for many elderly patients to complete. Treatment delivered through videophones placed in the homes of individuals with IPD offers an alternative and could improve accessibility of treatment if the results were the same. This study compared the outcomes of LSVT delivered via videophones to the outcomes of traditional treatment delivered face-to-face.

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Abstr actThe objective of this research was to assess the effects of an application of telerehabilitation reducing time and financial obligation on caregiver burden among eleven caregivers of elderly persons with Parkinson's disease. Clients (care receivers) participated in speech therapy delivered via videophones in their homes; the protocol required 16 treatments delivered four times a week for four weeks. At the conclusion of treatment, caregivers completed a structured interview about the impact of telerehabilitation on time and financial aspects of the burden of care. On average, this speech therapy protocol delivered by videophones saved 48 hours of time, more than 92 hours of work time, and $1024 for each caregiver. Savings were significant and previous research demonstrated nearly equal outcomes using the videophone delivery method. Implications for practice and research are discussed.

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