Low-bandwidth telemedicine for remote orthotic assessment

Abstract

A model for performing remote orthotic assessments using low-bandwidth computer communication technology (video conferencing) was developed, tested, and evaluated. System evaluation involved comparing a series of remote assessments with on-site assessments. While most on-site and on-line results were similar, discrepancies which occurred were attributed to between-clinician differences, measurement technique differences, technical and learning obstacles at the start of the project, and within subject variations during the day. On-line assessment efficiency improved with each on-line session and corresponded with increased confidence in the system, easier system use, and better overall satisfaction. An on-line debriefing session was held with all project clinicians. These clinicians supported continued use of the communication system for rehabilitation consultation and education. Clinically, preliminary face-to-face meetings and a regular practice schedule were recommended. Technically, the system was considered good; however, suggested improvements included using a high quality speaker-phone system, streamlining the video capture process, and providing more reliable telecommunication connections.

Low-bandwidth telerehabilitation for patients who have undergone total knee replacement: Preliminary results

“…Relatively few studies have investigated the feasibility of low-bandwidth therapeutic interventions at a distance since the development of telerehabilitation in 1997 3 . Studies of the reliability of evaluation with low-bandwidth musculoskeletal telerehabilitation have been conducted in the areas of: anklefoot orthotics 4 , orthopaedic outpatients 5 , seating and wheelchair evaluations 6 , administration of the Kohlman Evaluation of Living Skills and the Canadian Occupational Performance Measure 7 , knee range of motion 8,9 , upper-extremity rehabilitation after stroke 10 , and muscle strength and assessment of gait 9 . In addition, telerehabilitation interventions have been evaluated in the areas of wheelchair prescription, foot care, gait problems, orthotics, prosthetics, arm weakness/joint degradation and communication disorders 11 .…”

Physical rehabilitation using telemedicine

“…3 Researchers from the Rehabilitation Centre in Ottawa, Canada continued this work using PC-based videoconferencing for rehabilitation consultations, including the remote management of patients requiring prosthetic and orthotic devices. [4][5][6] A number of papers from the US have described telerehabilitation applications for the assessment and management of clients with neurological impairment 7,8 and more recently, researchers from the University of Hong Kong have demonstrated positive outcomes when using videoconferencing to conduct community-based stroke rehabilitation programmes.…”

The validity of video clips in the diagnosis of gait disorder

“…They reported discrepancies between on-site and remote assessment for inversion/eversion, lateral trunk flexion, excessive knee flexion and knee hyperextension (all with 71% similarity score). 12 These approaches all involved realtime interaction with patients, which can be expensive and difficult to organize. The use of recorded video clips provides the advantages of convenience and low cost associated with asynchronous assessment.…”