Physical Medicine and Rehabilitation Clinics of North America
Enhancing Quality of Life through Telerehabilitation
Section snippets
An alternative model of telerehabilitation to promote quality of life
Much of the research literature on telerehabilitation has focused on the outcome measure of decreasing costs, saving travel time, and improving access to specialty services and expert practitioners.6 The rationale proposed to support the exploration and implementation of telerehabilitation has been essentially based on the use of various technologies to address geographic and economic barriers, and potentially enhance cost effectiveness. An alternative perspective is that the potential benefit
Telerehabilitation technologies
Traditional models of telemedicine began with videoconference interactions between a service provider, such as a physician or nurse, directly to a patient at the remote site. In recent years the model has been broadened, and the technologies supporting the remote service provision have diversified dramatically. This section briefly addresses models and then provides an overview of telerehabilitation technologies.
Models for providing telerehabilitation may provide services either synchronously
Telerehabilitation approaches to enhance quality of life
Rehabilitation services often comprise a scope of services, beginning with assessment, moving on to intervention, and then assure patient success and outcome via follow-up services. Telerehabilitation strategies and applications provide additional venues to allow for provision of rehabilitation services at a distance where persons live, work, and play. Not only has home and community-based rehabilitation been found to be preferred by persons with disabilities,37 provision of services within the
Obstacles and opportunities
There are multiple challenges and potential barriers to the implementation of telerehabilitation services in everyday clinical practice. Primary among them are concerns held by clinicians, policy issues with reimbursement and licensure, privacy, and confidentiality, and the limited scope of current research on telerehabilitation.
Schopp and colleagues52 identified several reasons for the decreased satisfaction of clinicians that is relevant to many applications of telerehabilitation. Of note, it
Resources
Much of the clinical work and research being done in telerehabilitation is not described in common rehabilitation journals or resources, but a familiarity with professional resources in telemedicine will provide a venue to explore applications that may have direct relevance to rehabilitation. Journals include Telemedicine and e-health, Cyberpsychology and Behavior, and the Journal of Telemedicine and Telecare. Given the emphasis on telemedicine in the military and the Veterans Healthcare
Summary
Telerehabilitation is an emerging method of delivering rehabilitation services that uses technology to serve clients, clinicians, and systems by minimizing the barriers of distance, time, and cost. The driving force for telerehabilitation has been as an alternative to face-to-face rehabilitation approaches to reduce costs, increase geographic accessibility, or act as a mechanism to extend limited resources. Most of the literature on telerehabilitation targets these needs, and justifies the use
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This work was supported by The Rehabilitation Engineering Research Center (RERC) on Telerehabilitation, funded by NIDRR, US Department of Education, Washington DC, Grant #: H133E040012.