Telerehabilitation: Review of the State-of-the-Art and Areas of Application

Abstract

BackgroundTelemedicine applications have been increasing due to the development of new computer science technologies and of more advanced telemedical devices. Various types of telerehabilitation treatments and their relative intensities and duration have been reported.ObjectiveThe objective of this review is to provide a detailed overview of the rehabilitation techniques for remote sites (telerehabilitation) and their fields of application, with analysis of the benefits and the drawbacks related to use. We discuss future applications of telerehabilitation techniques with an emphasis on the development of high-tech devices, and on which new tools and applications can be used in the future.MethodsWe retrieved relevant information and data on telerehabilitation from books, articles and online materials using the Medical Subject Headings (MeSH) “telerehabilitation,” “telemedicine,” and “rehabilitation,” as well as “disabling pathologies.”ResultsTelerehabilitation can be considered as a branch of telemedicine. Although this field is considerably new, its use has rapidly grown in developed countries. In general, telerehabilitation reduces the costs of both health care providers and patients compared with traditional inpatient or person-to-person rehabilitation. Furthermore, patients who live in remote places, where traditional rehabilitation services may not be easily accessible, can benefit from this technology. However, certain disadvantages of telerehabilitation, including skepticism on the part of patients due to remote interaction with their physicians or rehabilitators, should not be underestimated.ConclusionsThis review evaluated different application fields of telerehabilitation, highlighting its benefits and drawbacks. This study may be a starting point for improving approaches and devices for telerehabilitation. In this context, patients’ feedback may be important to adapt rehabilitation techniques and approaches to their needs, which would subsequently help to improve the quality of rehabilitation in the future. The need for proper training and education of people involved in this new and emerging form of intervention for more effective treatment can’t be overstated.

Virtual Reality for Neurorehabilitation: Insights From 3 European Clinics

“…Over the last decade, interest in nonimmersive virtual reality (VR) for rehabilitation has led to the development of low‐cost systems capable of providing personalized task practice for the rehabilitation of motor impairment in clinical [1‐3] and home settings [4]. This field has grown partly due to technological advances in motion capture and cloud computing, making technologies more accessible for clinicians to test and developers in this field to produce content for.…”

The Use of Telerehabilitation Technologies for Cardiac Patients to Improve Rehabilitation Activities and Unify Organizations: Qualitative Study (Preprint)

“…We have not identified studies with this finding, and in their review of the state-of-the art on telerehabilitation. Peretti found that future research needs to focus more on healthcare professionals and patients feedback in order to develop the kind of telerehabilitation technologies and programs that can meet patients' needs [20].…”

“…Evaluations of cardiac telerehabilitation programs conclude that studies tend to be heterogeneous with respect to patients, intervention, use of technologies and outcome measures; moreover, the cardiac telerehabilitation programs often lack nutritional counseling or psychosocial management [19,20]. Studies focusing solely on exercised-based cardiac telerehabilitation have been shown to be at least as effective as center-based rehabilitation for improving functional capacity and reducing cardiovascular risk factors [21].…”

Development and implementation of technologies for physical telerehabilitation in Latin America:

“…Telerehabilitation is comprised of a set of instruments and protocols aimed at providing access to rehabilitation services to patients at geographically distant locations [13]. Previous works have reported some important benefits for patients in specific rehabilitation programs that use information and communication technologies.…”

“…Thus, telerehabilitation is still considered a growing alternative to traditional face-to-face therapy that employs technological solutions to remotely provide rehabilitation care in both clinical centers and in-home programs. This strategy should not be seen as a technology itself, but as the use of new emerging technologies-such as motion capture sensors, wearable devices and computational tools, among others-to provide healthcare assistance to patients in their own home or residence, which reduces high costs and discomfort due to long patient transportation [13]. Consequently, telerehabilitation systems or programs are developed to cover the high demand of disabled people with different types of physical impairments in developed and high-income countries are reported in different sources of scientific and dissemination literature.…”