Pre-admission orthopaedic occupational therapy home visits conducted using the Internet

We evaluated the feasibility and accuracy of conducting occupational therapy home visits using the Internet. Studies were conducted at the homes of 40 patients who were scheduled to undergo a total hip or knee replacement: home visits were conducted, on the same day, by both a face-to-face therapist and an online therapist. The online therapist conducted the visit via a low-speed, dial-up Internet connection using a specially developed telerehabilitation system. This system combines real-time videoconferencing (320 x 240 pixel resolution) with a suite of calibrated assessment tools which the operator can use to measure real-scale angular displacement/velocity and linear distances during the videoconference. Both therapists completed a home environment questionnaire, assessed patients' transfer ability and measured the heights of six objects/pieces of furniture. For the questionnaire items which related to variables in the home environment, the mean percentage exact agreement was 98.9% (SD 2.6; range 90-100), while there was 100% agreement on the items related to transfers. The mean absolute difference in measured heights between the two therapists ranged from 0.1-3.3 cm. The results suggest that conducting pre-admission orthopaedic occupational therapy home visits via the Internet is both feasible and accurate.