Telerehabilitation--the use of telecommunications technology to provide rehabilitation and long-term support to people with disabilities--offers exciting possibilities for the delivery and support of assistive technology services. This article describes the experiences of a specialty hospital serving persons with disabilities in exploring telerehabilitation to support assistive technology use in the home. Four case studies are presented to illustrate how telerehabilitation may be used in relation to seating evaluation, evaluation of home accessibility, setup of computer access systems, and training in use of augmentative communication devices.

Objective: To determine which of three approaches to care produces the lowest incidence of pressure ulcers, promotes the most effective care of sores that develop, and leads to the fewest hospitalizations in newly injured patients with spinal cord injury after discharge.Methods: Spinal cord injury patients (n = 12) were recruited for a telehealth intervention after initial injury, and matched cases were recruited for telephone counseling and standard care groups. Patients were monitored for 6–8 months after discharge.Results: The video group had the greatest number of reported and identified pressure ulcers. Differences in health care utilization between the video and telephone telehealth groups were small. The standard care group reported the lowest number of pressure ulcers and lowest frequency of health care utilization. Substantial differences existed in employment rates before and after injury. The video group had the lowest pre-injury rate of employment and the highest post-injury rate of employment.Conclusions: Tracking pressure ulcer incidence, particularly stage I sores, is difficult. Self-report is likely to lead to substantial underreporting. Similarly, self-report on health care utilization over extended periods may lead to undercounting of encounters. Telehealth interventions appear to improve ulcer tracking and management of all ulcer occurrences. Video interventions may affect outcomes, such as employment rates, which are not conventionally measured.

We carried out a feasibility study of the use of a home telecare intervention to promote skin and other self-care activities for clients with spinal cord injuries (SCIs) following their discharge from a rehabilitation facility. Eleven clients (mean age 38 years) participated in at least three video-sessions over a minimum of six weeks. The equipment used was a video-phone which could transmit both audio and still images over an ordinary telephone line. Video-sessions were followed by, or interspersed with, telephone calls. There was an average of 10 video-calls (range 3-25) and an average of six telephone calls (range 0-22) per client. The average length of the consultations was 23 min (range 15-34 min). The overall impressions of the 11 clients were very positive. Weekly telecare sessions for four to six weeks, followed by telephone counselling alone every other week for another four weeks, appears to be the appropriate sequence for most SCI clients.

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