Wheelchair Seating Assessment and Intervention: A Comparison between Telerehabilitation and Face-to-Face Service

Abstract

Abstr actThis study compared outcomes of wheelchair seating and positioning interventions provided by telerehabilitation (n=10) and face-to-face (n=20; 10 in each of two comparison groups, one urban and one rural). Comparison clients were matched to the telerehabilitation clients in age, diagnosis, and type of seating components received. Clients and referring therapists rated their satisfaction and identified if seating intervention goals were met. Clients recorded travel expenses incurred or saved, and all therapists recorded time spent providing service. Wait times and completion times were tracked. Clients seen by telerehabilitation had similar satisfaction ratings and were as likely to have their goals met as clients seen faceto-face; telerehabilitation clients saved travel costs. Rural referring therapists who used telerehabilitation spent more time in preparation and follow-up than the other groups. Clients assessed by telerehabilitation had shorter wait times for assessment than rural face-to-face clients, but their interventions took as long to complete.

Telehealth delivery of remote assessment of wheelchair and seating needs for adults and children: A scoping review (Preprint)

“…In a well-designed casecontrol study (N=29), wait time for provision of wheelchair and seating assessment differed significantly for wheelchair users who live 'out of region' (i.e., very remotely from specialist centers) for IP-WS assessment (F(2, 27)=3.90, P=.03) compared to wheelchair users who lived locally (56 days v 29 days respectively). However no difference in wait times was observed irrespective of geographic location of wheelchair user for patients receiving tele-WS assessment (32 days) [24]. Notably, 'out of region' wheelchair-users in this study reported that through tele-WS assessment they accessed specialist assessment services otherwise not available to them, due to where they lived.…”

“…In relation to patient-centered outcomes of tele-WS assessment, research so far has focused on feasibility issues, with only two of the more recent studies [23,24] exploring its effectiveness in achieving patient-centered outcomes. All outcomes are reported in Table 3.…”

“…In relation to service design and efficiency, Lemaire et al [23] and Barlow et al [24] have measured the time taken for assessments in person and using TR. Barlow et al (2009) also reported differences in waiting times for patients to be assessed when tele-WSA was introduced as an option.…”

“…Patient-reported functional ability [25] and goal achievement [24] related to wheelchair prescription was reported as equivalent between IP-and tele-WS assessment (see Table 3 for inter-rater reliability scores). No studies reported adverse events or highly unsatisfactory outcomes.…”

“…Publication dates were from 1998 to 2010 with 5/13 (39%) of publications occurring in 2010. Research methods employed in the 9 studies were largely exploratory, and some studies used more than one method, including quasi experimental designs (n=8), [21][22][23][24][25][26][27][28][29], case reports (n=2), [30,31] or studies wholly or partly inclusive of qualitative methods exploring stakeholder views about remote wheelchair assessment (n=2) [28,32]. Of those studies comparing tele-and IP-WS assessment, only one study included randomisation [27].…”