A systematic review of the methodology of telemedicine evaluation in patients with postural and movement disorders

Abstract

We reviewed the methodology used in telemedicine research concerning patients with postural and movement disorders. Literature searches were performed using various computerized databases through to October 2005. Twenty-two studies met the criteria for review. Two broad models of telemedicine delivery were represented in the literature: (1) telemedicine between health-care professionals at each telemedicine site (n=16) and (2) telemedicine between health-care professionals and a patient at a remote site (n=6). Disparate research methodologies were used to investigate these two models. Most studies were limited to investigating the technical feasibility and acceptability of a telemedicine service rather than focusing on the overall effect of introducing the telemedicine service into routine health care. Nonetheless, it is possible to conclude that telemedicine is acceptable for both patients and professionals when used in rehabilitation. Since the two models of telemedicine evaluation tend to explore different outcomes (diagnostic accuracy versus health status), it is recommended that separate methodologies should be used. In contrast to evaluations of telemedicine model 2, randomized controlled trials appear to be less valuable for telemedicine model 1.

Patients' experiences of telerehabilitation at home after shoulder joint replacement

“…Further benefits include increased care delivery, increased professional education, provision of care not previously delivered, quality control in screening programmes and reduced health-care costs. 12,13…”

Evidence of benefit from telerehabilitation in routine care: a systematic review

“…Reviews of TR have reported that there is promise in this area, but have drawn attention to the limitations of available evidence. Huis et al 3 reported that evaluation of the effects of some categories of TR interventions is still in its early stages, with an emphasis on technical feasibility and acceptability. Such limitations were also considered by Russell who noted that much research in telemedicine for physical rehabilitation has been technology-focused, and with small sample research designs.…”

Gaps in the systematic reviews of the telemedicine field

“…The search identified 55 systematic reviews. 1–55 The details of their selection are summarised in Table 1. The categories in which most reviews had been conducted were home telecare (16) and general (16), which together accounted for over half of the published papers which were selected for the present study (see Table 2).…”