title: Development of a teletechnology protocol for in-home rehabilitation.
abstract: Our ability to provide in-home rehabilitation is limited by distance and available personnel. We may be able to meet some rehabilitation needs with videoconferencing technology. This article describes the feasibility of teletechnology for delivering multifactorial, in-home rehabilitation interventions to community-dwelling adults recently prescribed a mobility aid. We used standard telephone lines to provide two-way video and audio interaction. The interventions included prescription of and/or training in functionally based exercises, home-hazard assessment, assistive technology, environmental modifications, and adaptive strategies. Patients were evaluated in three transfer and three mobility tasks, and appropriate treatment was provided over the course of four visits. To date, 13 of the 14 subjects enrolled in the rehabilitation study have completed all four visits (56 visits total). Equipment-related problems were most common early in the study, particularly on the initial visit to a subject's house. We identified (mean +/- standard deviation [SD]) 13.1 +/- 7.9 mobility/self-care problems per subject and made 12.5 +/- 8.3 recommendations per subject to address those problems. At 6-week follow-up, 60.1 percent of our recommendations had been implemented. The greatest number of problems was identified for tub transfers (mean +/- SD = 3.4 +/- 1.4), the greatest number of recommendations was made for toilet transfers (mean +/- SD = 3.1 +/- 3.4), and the most frequently implemented recommendations were for transition between locations. Overall, our results show promise that both the telerehabilitation technology and intervention procedures are feasible.
authors.affiliation: Durham Department of Veterans Affairs Medical Center (VAMC), Physical Medicine and Rehabilitation Service, Durham, NC 27705, USA. helen.hoenig@med.va.gov
authors.forename: Helen
authors.initials: H
authors.lastname: Hoenig
authors.forename: Jon A
authors.initials: JA
authors.lastname: Sanford
authors.forename: Tina
authors.initials: T
authors.lastname: Butterfield
authors.forename: Patricia C
authors.initials: PC
authors.lastname: Griffiths
authors.forename: Peg
authors.initials: P
authors.lastname: Richardson
authors.forename: Katina
authors.initials: K
authors.lastname: Hargraves
mesh_terms: D020811:Biomedical Technology; D006233:Persons with Disabilities / Q000534:rehabilitation*; D005240:Feasibility Studies; D005544:Forecasting; D006297:Health Services Accessibility; D006699:Home Care Services / Q000592:standards* / Q000600:supply & distribution; D006801:Humans; D009048:Motor Skills; D009788:Occupational Therapy / Q000379:methods / Q000592:standards; D010353:Patient Education as Topic / Q000379:methods* / Q000592:standards; D026741:Physical Therapy Modalities / Q000592:standards / Q000639:trends; D012656:Self-Help Devices; D017216:Telemedicine / Q000592:standards*; D049269:Videoconferencing / Q000592:standards*