Pediatric telerehabilitation medicine: Making your virtual visits efficient, effective and fun

Abstract

The COVID-19 pandemic has accelerated many changes in medicine including the transition from providing care in person to providing care via technology enabled telemedicine. The benefits of telemedicine visits with a Pediatric Rehabilitation Medicine (PRM) provider, also known as telerehabilitation medicine visits, are numerous. Telerehabilitation medicine provides an opportunity to deliver timely, patient and family-centric rehabilitation care while maintaining physical distance and reducing potential COVID-19 exposure for our patients, their caregivers and medical providers. Telerehabilitation medicine also allows for access to PRM care in rural areas or areas without medical specialty, virtual in-home equipment evaluation, and reduced travel burden. Because of these and many other benefits, telerehabilitation medicine will likely become part of our ongoing model of care if barriers to telemedicine continue to be lowered or removed. This paper is intended to establish a foundation for pediatric telerehabilitation medicine visit efficiency and effectiveness in our current environment and into the future.

Transition to Multidisciplinary Pediatric Telerehabilitation during the COVID-19 Pandemic: Strategy Development and Implementation

“…This may have limited the ability of therapists, who did not undergo training for use of telerehabilitation, to use the technology optimally. Indeed, existing evidence suggests that assessment in telerehabilitation may be feasible and valid for neurological [34] and orthopaedic [35] conditions (including in children), supporting the idea that training and technology may be key to improving these aspects of telerehabilitation usage [36]. Our results further showed that with younger children, the ability to communicate feedback, grade levels of difficulty and provide guidance for parents was diminished.…”

“…The current work, although not directly comparing telehealth with face-to-face treatment, extends previous work to demonstrate that effective telerehabilitation can be obtained across different health professions also under extreme circumstances. This may warrant more attention as protocols for telehealth are developed and disseminated, and the pandemic has accelerated these processes [25,36]. With the new competencies telerehabilitation requires from clinical staff [16], our results showed that clinicians were able (given the necessity) to adapt to the novel conditions.…”

Lessons Learned during a Naturalistic Study of Online Treatment for Pediatric Rehabilitation

“…The approach of the Mayo Clinic team [ 20 ] illustrates this response. To prepare children, families and therapists for tele-rehabilitation consultations necessitated by the COVID-19 pandemic social distancing requirements, they developed checklists and guidelines that were specific for medical diagnoses and types of intervention.…”

The Telemedicine-Based Pediatric Examination of the Back and Lower Limbs: A Narrative Review

“… 2 Face-to-face consultations for pediatric patients are being replaced by videoconference meetings or telephone encounters, carrying their own set of advantages and limitations. 3 , 4 For one, videoconference-based orthopedic consultations have been shown to be cost-effective and do not result in serious adverse events. 5 , 6 Additionally, telemedicine appointments have been shown to provide convenience to the patient and provider, leading to increased satisfaction, as well as increased access to specialized care in rural/remote areas.…”

“…While many resources exist to guide aspects of a virtual musculoskeletal examination, specific recommendations for the pediatric population are lacking. 4 Therefore, the aim of this narrative review was to provide the clinician with a summary of written guidelines to facilitate specific physical examination techniques on children aged 3–18 years, with or without the help of a caregiver. Most of these techniques are based on validated physical exam maneuvers performed during in-person encounters which have been modified to enable the child and caregiver to self-perform the maneuvers.…”