title: Bidirectional and multi-user telerehabilitation system: clinical effect on balance, functional activity, and satisfaction in patients with chronic stroke living in long-term care facilities.
abstract: BACKGROUND
  The application of internet technology for telerehabilitation in patients with stroke has developed rapidly.
  
  
  OBJECTIVE
  The current study aimed to evaluate the effect of a bidirectional and multi-user telerehabilitation system on balance and satisfaction in patients with chronic stroke living in long-term care facilities (LTCFs).
  
  
  METHODS
  This pilot study used a multi-site, blocked randomization design. Twenty-four participants from three LTCFs were recruited, and the participants were randomly assigned into the telerehabilitation (Tele) and conventional therapy (Conv) groups within each LTCF. Tele group received telerehabilitation but the Conv group received conventional therapy with two persons in each group for three sessions per week and for four weeks. The outcome measures included Berg Balance Scale (BBS), Barthel Index (BI), and the telerehabilitation satisfaction of the participants.
  
  
  METHODS
  A telerehabilitation system included "therapist end" in a laboratory, and the "client end" in LTCFs. The conventional therapy was conducted in LTCFs.
  
  
  RESULTS
  Training programs conducted for both the Tele and Conv groups showed significant effects within groups on the participant BBS as well as the total and self-care scores of BI. No significant difference between groups could be demonstrated. The satisfaction of participants between the Tele and the Conv groups also did not show significant difference.
  
  
  CONCLUSIONS
  This pilot study indicated that the multi-user telerehabilitation program is feasible for improving the balance and functional activity similar to conventional therapy in patients with chronic stroke living in LTCFs.
authors.affiliation: School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei 100, Taiwan. khlin@ntu.edu.tw.
authors.forename: Kwan-Hwa
authors.initials: KH
authors.lastname: Lin
authors.affiliation: Department of Management Information Systems, Central Taiwan University of Science and Technology, Taichung 406, Taiwan. chchen@ctust.edu.tw.
authors.forename: Chin-Hsing
authors.initials: CH
authors.lastname: Chen
authors.affiliation: Institute of Biomedical Engineering, National Yang-Ming University, Taipei 112, Taiwan. d87921040@ntu.edu.tw.
authors.forename: You-Yin
authors.initials: YY
authors.lastname: Chen
authors.affiliation: Department of Computer Science and Information Engineering, Minghsin University of Science and Technology, Hsinchu 304, Taiwan. wthuang@must.edu.tw.
authors.forename: Wen-Tzeng
authors.initials: WT
authors.lastname: Huang
authors.affiliation: Department of Physical Medicine and Rehabilitation, College of Medicine, National Taiwan University and National Taiwan University Hospital, Taipei 100, Taiwan. jslai@ntu.edu.tw.
authors.forename: Jin-Shin
authors.initials: JS
authors.lastname: Lai
authors.affiliation: Department of Nursing, Central Taiwan University of Science and Technology, Taichung 406, Taiwan. smyu1946@ctust.edu.tw.
authors.forename: Shang-Ming
authors.initials: SM
authors.lastname: Yu
authors.affiliation: Department of Management Information Systems, Central Taiwan University of Science and Technology, Taichung 406, Taiwan. ronchang@ctust.edu.tw.
authors.forename: Yuan-Jen
authors.initials: YJ
authors.lastname: Chang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008134:Long-Term Care / Q000379:methods*; D008297:Male; D010549:Personal Satisfaction; D010865:Pilot Projects; D004856:Postural Balance / Q000502:physiology*; D000071939:Stroke Rehabilitation; D017216:Telemedicine / Q000379:methods*