Low-bandwidth, Internet-based videoconferencing for physical rehabilitation consultations

Abstract

Low-bandwidth, Internet-based videoconferencing was used to provide physical rehabilitation consultation services for eight community hospitals. Videoconferencing and file transmission used a PC and modem. A separate telephone line was used for voice. Over 21 months, 47 physical rehabilitation consultations were completed for communication disorders, foot care, gait problems, orthotics, prosthetics, arm weakness and wheelchair prescription. Consultations were approximately 40 min long. Clinician questionnaires were completed by 47 individuals. While more than 80% of the questionnaire responses supported the telemedicine approach, remote clinicians rated their satisfaction higher than did the specialists. Client questionnaires were completed by 24 individuals (a response rate of 51%). All clients were comfortable with and had confidence in the teleconsultations.

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

“…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].…”

“…Observational data on either therapist satisfaction with tele-WS assessment only (n=2) [23,28] and/or client satisfaction with tele-WS assessment (n=3) [26] was reported in some studies. Stakeholders whose views were examined (n= 6)…”

“…The most common reason for compromised quality was inappropriate or poorly applied study design including limited control of bias, insufficient methodological description and small sample sizes. Measures used to collect satisfaction data included surveys designed for specific studies [10,23] and one standardised measure of equipment service satisfaction, the Quebec User Equipment Satisfaction with assistive Technology (QUEST: [33] [24]. …”

“…Such people were remote non-specialist health professional assessors (n=6), family members (n=1), rehabilitation assistants (n=1) or wheelchair technicians (n=1). Two studies reported a protocol for the use of assessment technology [23,27] but none systematically described how WS assessment was conducted in a way that could be replicated, for either tele-or IP-WS assessment; the type of wheelchair users it might (or might not) be appropriate for; the level of training of assessors in generic WS assessment or training provided in the use of the technology. Similarly, no guideline or consensus statement regarding the process of wheelchair and seating assessment was referenced in any studies.…”

“…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.…”