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Telerehabilitation wheeled mobility and seating assessments compared with in person
Richard M Schein1, Mark R Schmeler, Margo B Holm
1Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA 15206, USA. rms35@pitt.edu
Objective:
To evaluate the equivalency of wheeled mobility and seating assessments delivered under 2 conditions: in person (IP) at a local clinic and via Telerehabilitation at remotely located clinics.
Design:
The study used a prospective, multicenter controlled nonrandomized design to investigate wheeled mobility and seating assessments.
Setting:
Five wheelchair clinics in Western Pennsylvania.
Participants:
Participants (N=98) in need of new wheeled mobility and seating were recruited and consented for IP assessments at the Center for Assistive Technology (n=50) and Telerehabilitation (n=48) assessments at remotely located clinics.
Interventions:
The telerehabilitation condition used a custom videoconferencing system to connect a wheeled mobility and seating expert at the University of Pittsburgh's Rehabilitation Engineering Research Center on Telerehabilitation to a remote clinic.
Main Outcome Measures:
Study findings were based on the level of function the participants showed with their new wheeled mobility and seating devices as measured by using the Functioning Everyday with a Wheelchair (FEW) outcome tool.
Results:
The results revealed no significant differences between the FEW pretest average or item scores for the 2 conditions or the FEW posttest average or item scores except for the FEW transportation item. The average FEW and FEW item scores reached the established clinically relevant pretest-posttest difference of 1.85, and the change scores were significantly different. The difference between FEW means based on posttest confidence intervals indicated that telerehabilitation was equally effective as IP rehabilitation.
Conclusions:
An expert practitioner located at least 125 miles away from each of the remote sites used a secured videoconferencing system to consult from a geographic distance on wheeled mobility and seating evaluations via telerehabilitation. Compared with participants receiving standard IP care, the telerehabilitation treatment condition was equally effective on all but 1 outcome.
