no differences were found between co-located and remote assessments except for some cases using screen-based ROM measures. Remote ROM tests using snapshots and a virtual goniometer were preferred. A digital dynamometer added no additional information to a visually-based remote MMT assessment.

Abstract-This study explored the equivalence of physical function assessment by physical therapists (PTs) during faceto-face and remote administration of the European Stroke Scale (ESS) and the Functional Reach Test (FRT) to 26 subjects with a history of stroke. Patients were randomized to remote or face-to-face administration groups. Each patient was simultaneously rated by both the face-to-face and remote PTs. The PTs were blinded to each other's results. Equivalence was set at the 95% limits of agreement. When the face-to-face PT directed the patient, the two PTs reported equivalent values in more than 90% of the patients for the FRT and for all ESS components, with the exception of gait (83%) and maintaining leg position (85%). When the remote PT directed the patient, the two PTs reported equivalent values in more than 90% of the patients for the FRT and more than 83% for all ESS components. Televideo assessment of function by PTs is substantially equivalent to a face-to-face encounter.

Telerehabilitation is the provision of rehabilitation services at a distance using electronic information and communication technologies. This paper describes two clinical programs that utilize videoconferencing to provide rehabilitation specialist consultations to individuals living in remote areas. Needs assessments for the two areas revealed that local clinicians were interested in access to specialty consultation. Administrative processes and a data collection tool were developed for these programs. High speed videoconferencing that allows for real-time audio and video interaction was used. Each consultation includes the patient, the local caregivers and specialists from our facilities interacting via videoconferencing. A total of 117 telerehabilitation encounters have been completed. All consultations resulted in changes to the plan of care. Clinicians who participated in the projects consistently rated the clinical effectiveness of teleconsults as good or excellent. Thirty-eight consultations have been neurologic in nature. Of that set, 25 of the visits were initial assessments, and thirteen were follow-up visits. Two case studies of individuals with neurologic diagnoses are presented. Recommendations to others who are providing rehabilitation services via telehealth technologies are included. The authors conclude that the care of individuals with neurologic issues can be augmented and supported via specialty consultation using telehealth technology.

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