title: Tele-rehabilitation service delivery journey from prototype to robust in-home use.
abstract: The purpose of this study is to present a retrospective study on clients with Acquired Brain Injury (ABI) enrolled in a tele-motion-rehabilitation service program for two or more months.
  
  
  
  Data from 82 clients (46 males; 74 with ABI), aged 22-85 years, are reported. The Kinect-based CogniMotion System (ReAbility Online, Gertner Institute, Tel Hashomer, Israel) provided services that included 30-min biweekly sessions. Participants were evaluated prior to and 2 months following the commencement of service with clinical assessments that measured movements and function of the weaker upper extremity and cognitive abilities.
  
  
  
  Clients enrolled in the service had intact or mild cognitive impairment, mild-moderate motor impairment but little use of their weak upper extremity for daily activities. They were satisfied with the service and reported high levels of system usability. Post-intervention clinical assessments were performed on about half of the participants after 2 months; significant improvements in active movements of the weak upper extremity, shoulder flexion range of motion and in the Trail Making Test were found (p < 0.05).
  
  
  
  The service appears to be feasible for people with ABI and effective in important clinical outcomes related to improvements in upper extremity function. Implications for Rehabilitation Tele-rehabilitation provided with Microsoft Kinect 3D sensor virtual reality tracking system is feasible for people with Acquired Brain Injury. People with Acquired Brain Injury in the chronic stage were satisfied with the tele-rehabilitation service and perceived it as beneficial to improve their motor and cognitive abilities The CogniMotion System service appears to be effective in important clinical outcomes related to improvements in upper extremity function.
authors.affiliation: a ReAbility Online, Gertner Institute for Epidemiology and Health Policy Research , Tel Hashomer , Israel.|b Center of Advanced Technologies in Rehabilitation , Sheba Medical Center , Tel Hashomer , Israel.|c Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences , University of Haifa , Haifa , Israel.
authors.forename: Rachel
authors.initials: R
authors.lastname: Kizony
authors.affiliation: a ReAbility Online, Gertner Institute for Epidemiology and Health Policy Research , Tel Hashomer , Israel.|c Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences , University of Haifa , Haifa , Israel.
authors.forename: Patrice L
authors.initials: PL
authors.lastname: Weiss
authors.affiliation: a ReAbility Online, Gertner Institute for Epidemiology and Health Policy Research , Tel Hashomer , Israel.
authors.forename: Sharon
authors.initials: S
authors.lastname: Harel
authors.affiliation: a ReAbility Online, Gertner Institute for Epidemiology and Health Policy Research , Tel Hashomer , Israel.
authors.forename: Yoram
authors.initials: Y
authors.lastname: Feldman
authors.affiliation: d Neurological Rehabilitation Department, Sheba Medical Center , Tel Hashomer , Israel.
authors.forename: Alexei
authors.initials: A
authors.lastname: Obuhov
authors.affiliation: d Neurological Rehabilitation Department, Sheba Medical Center , Tel Hashomer , Israel.|e Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel.
authors.forename: Gabi
authors.initials: G
authors.lastname: Zeilig
authors.affiliation: a ReAbility Online, Gertner Institute for Epidemiology and Health Policy Research , Tel Hashomer , Israel.
authors.forename: Mordechai
authors.initials: M
authors.lastname: Shani
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001930:Brain Injuries / Q000534:rehabilitation*; D005260:Female; D017144:Focus Groups; D006699:Home Care Services; D006801:Humans; D007557:Israel; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000534:rehabilitation*; D010549:Personal Satisfaction; D016059:Range of Motion, Articular; D012044:Regression Analysis; D012189:Retrospective Studies; D000069350:Telerehabilitation / Q000379:methods*; D034941:Upper Extremity / Q000503:physiopathology*; D063367:Virtual Reality Exposure Therapy; D055815:Young Adult
keywords: Tele-rehabilitation; acquired brain Injury; remote intervention; virtual-reality