Clinical Telerehabilitation: Applications for Physiatrists

Abstract

Telemedicine offers an innovative approach to increase access to rehabilitation medicine services for patients who live in areas where physiatrists are scarce or absent. This article reviews the current status of telerehabilitation services delivered through real-time videoconferencing to provide support, assessment, and interventions to individuals with impairments or disabilities. A literature review demonstrates various uses of telerehabilitation by physical therapists, occupational therapists, speech and language pathologists, audiologists, recreational therapists, neuropsychologists, nurses, other physician specialists, and physiatrists. We also provide more in-depth examples of 2 current programs that involve physiatrists: One furnishes telerehabilitation services to adult stroke survivors, and the other addresses the special health care needs of children with developmental disabilities. We discuss the benefits of using telemedicine via real-time videoconferencing to care for individuals with disabilities, outline the challenges of successfully implementing a physiatric telerehabilitation program, and finish with a list of potential applications for physiatrists interested in incorporating telemedicine into their practice. Further investigation of the use of telehealth technologies to deliver physiatric services, care coordination, and education is needed. We recommend that our professional societies develop and publish guidelines to facilitate development and use of telerehabilitation technologies to increase access to physiatric services.

Description of the CARE4STROKE programme: A caregiver‐mediated exercises intervention with e‐health support for stroke patients

“…Despite a lack of trials in this area (Laver et al, 2013), e‐health technology seems promising and is increasingly used (Gregory et al, 2011; White et al, 2014). The functionality and content of the current app and telerehabilitation services in C4S can be expanded.…”

“…We hypothesize that this app can support adherence to the programme by patient and caregiver and promote self‐management (Gregory, Alexander, & Satinsky, 2011; White, Janssen, Jordan, & Pollack, 2014). …”

The Effect of a Memory Training Application for a Patient with Traumatic Brain Injury

“…Most of these programs have focused on rehabilitation of physical disability or speech impairment 5,9,13,14,17,18) . In contrast, only a few studies have reported on telerehabilitation for cognition 7,8,10) .…”

“…These studies have been performed using internet-based virtual reality or computer software programs. With the rapid spread of tablet PCs and smartphones, many applications have been developed for rehabilitation 11,13,15,16,19,20) . Some studies have demonstrated the usefulness of smartphones for improvement of memory impairment [22][23][24] .…”

“…With the rapid development of modern technology and the use of computers in communications, many applications and telerehabilitation programs have been developed for rehabilitation various functions, including cognition [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] . However, little is known about applications for memory training based on telerehabilitation for patients with TBI.…”