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

Abstract

Background: Assessment of the wheelchair and seating needs of people with complex disabilities requires health professionals to have advanced training and experience, creating difficulties in accessing such specialist services for wheelchair users living outside of metropolitan areas. Use of telehealth technologies to enable remote assessment has been suggested as one way to improve accessibility to specialist assessment and reduce the cost of services, however no synthesis of this research is currently available to guide practice or research development.Objective: This scoping review synthesizes research to date on the effects and processes of telehealth enabled wheelchair and seating assessment and the perceptions of wheelchair users and healthcare providers of this mode of service delivery. Methods:A systematic search and scoping review of peer-reviewed publications and theses was undertaken. Five databases were searched including CINAHL, Embase, Medline, Psychinfo and Scopus followed by hand searching of reference lists and forward citations.Data extraction and synthesis was organised around each research objective. Results:From an initial identification of 1801 publications, 9 studies published in 13 documents met the inclusion criteria. Study quality and study design varied considerably. The effect of telehealth compared to in-person assessment was insignificant in all studies that compared effectiveness (n=2) in relation to wheelchair-user and assessor rated variables.Telehealth assessment improved accessibility for some wheelchair users (n=1). However the process of telehealth that was applied to wheelchair assessment was inadequately described in all studies. Qualitative studies (n= 2) revealed that wheelchair-users appraised telehealth wheelchair assessment more positively than assessors. Non-specialist, assisting assessors appraised telehealth assessment more positively than specialist assessors. It appeared that each stakeholder group appraised telehealth based on different criteria including accessibility, professional supportiveness and technical accuracy. No studies examined funder views.Conclusions: Preliminary research suggests telehealth wheelchair assessment may be as effective as in-person assessment. Furthermore, this approach is viewed favorably by wheelchair users and non-specialist assessors, while expert assessors have some hesitations.The literature to date has not provided adequate descriptions of the process undertaken during 3 remote wheelchair assessment. The process of remote wheelchair assessment requires clarification to further understandings of how telehealth can be used for greatest effect in this area.