title: Conditions of Use, Reliability, and Quality of Audio/Video-Mediated Communications During In-Home Rehabilitation Teletreatment for Postknee Arthroplasty.
abstract: Audio/video-mediated communication between patients and clinicians using videoconferencing over telecommunication networks is a key component of providing teletreatments in rehabilitation.
  
  
  
  The objectives of this study were to (1) document the conditions of use, performance, and reliability of videoconferencing-based communication in the context of in-home teletreatment (TELE) following total knee arthroplasty (TKA) and (2) assess from the perspective of the providers, the quality attributes of the technology used and its impact on clinical objectives.
  
  
  
  Descriptive embedded study in a randomized controlled trial using a sample of 97 post-TKA patients, who received a total of 1,431 TELE sessions. Technical support use, service delivery reliability, performance, and use of network connection were assessed using self-report data from a costing grid and automated logs captured from videoconferencing systems. Physical therapists assessed the quality and impact of video-mediated communications after each TELE session on seven attributes.
  
  
  
  Installation of a new Internet connection was required in 75% of the participants and average technician's time to install test and uninstall technology (including travel time) was 308.4 min. The reliability of service delivery was 96.5% of planned sessions with 21% of TELE session requiring a reconnection during the session. Remote technical support was solicited in 43% of the sessions (interventions were less than 3-min duration). Perceived technological impacts on video-mediated communications were minimal with quality of the overall technical environment evaluated as good or acceptable in 96% of the sessions and clinical objectives reached almost completely or completely in 99% of the sessions.
  
  
  
  In-home rehabilitation teletreatments can be delivered reliably but requires access to technical support for the initial setup and maintenance. Optimization of the processes of reliably connecting patients to the Internet, getting the telerehabilitation platform in the patient's home, installing, configuring, and testing will be needed to generalize this approach of service delivery.
authors.affiliation: 1 Université de Sherbrooke and Research Centre on Aging , Sherbrooke, QC, Canada .
authors.forename: Patrick
authors.initials: P
authors.lastname: Boissy
authors.affiliation: 1 Université de Sherbrooke and Research Centre on Aging , Sherbrooke, QC, Canada .
authors.forename: Michel
authors.initials: M
authors.lastname: Tousignant
authors.affiliation: 2 Université Laval , Quebec, QC, Canada .|3 Centre for Interdisciplinary Research in Rehabilitation and Social Integration , Quebec, QC, Canada .
authors.forename: Helene
authors.initials: H
authors.lastname: Moffet
authors.affiliation: 4 Université de Montréal and Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal , Montreal, QC, Canada .
authors.forename: Sylvie
authors.initials: S
authors.lastname: Nadeau
authors.affiliation: 1 Université de Sherbrooke and Research Centre on Aging , Sherbrooke, QC, Canada .
authors.forename: Simon
authors.initials: S
authors.lastname: Brière
authors.affiliation: 2 Université Laval , Quebec, QC, Canada .|5 IUSMQ Mental Institute Research Centre , Quebec, QC, Canada .
authors.forename: Chantal
authors.initials: C
authors.lastname: Mérette
authors.affiliation: 1 Université de Sherbrooke and Research Centre on Aging , Sherbrooke, QC, Canada .
authors.forename: Hélène
authors.initials: H
authors.lastname: Corriveau
authors.affiliation: 2 Université Laval , Quebec, QC, Canada .|6 CHU de Québec-Université Laval , Quebec, QC, Canada .
authors.forename: François
authors.initials: F
authors.lastname: Marquis
authors.affiliation: 1 Université de Sherbrooke and Research Centre on Aging , Sherbrooke, QC, Canada .|7 CHUS , Sherbrooke, QC, Canada .
authors.forename: François
authors.initials: F
authors.lastname: Cabana
authors.affiliation: 4 Université de Montréal and Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal , Montreal, QC, Canada .|8 Jean-Talon Hospital , Montreal, QC, Canada .
authors.forename: Pierre
authors.initials: P
authors.lastname: Ranger
authors.affiliation: 2 Université Laval , Quebec, QC, Canada .|6 CHU de Québec-Université Laval , Quebec, QC, Canada .
authors.forename: Étienne L
authors.initials: ÉL
authors.lastname: Belzile
authors.affiliation: 9 McGill University , Montreal, QC, Canada .|10 St. Mary's Hospital , Montreal, QC, Canada .
authors.forename: Ronald
authors.initials: R
authors.lastname: Dimentberg
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D020407:Internet / Q000592:standards; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012959:Socioeconomic Factors; D000069350:Telerehabilitation / Q000458:organization & administration* / Q000592:standards; D049269:Videoconferencing / Q000458:organization & administration* / Q000592:standards
keywords: human factors; technical quality; teletreatment; videoconferencing