Overcoming language barriers to provide telerehabilitation for COVID-19 patients: a two-case report

This report presents two cases of successful telerehabilitation delivery for patients quarantined due to COVID-19. One of the patients did not speak the therapists' language, whereas the other presented complete deafness.

We assembled a telerehabilitation system using commercial applications, including a remote-control application that minimizes the need for patient's input. The telerehabilitation comprised a combination of video calls with a physical therapist and a 20-minute exercise video. The first case was of a 72-year-old man who could only speak Cantonese, a language that none of the service providers could speak, making communication difficult. Therefore, telerehabilitation was provided using Google Translate to simultaneously translate the therapist's instructions in Japanese to Cantonese. The second case involved a 49-year-old man with neurofibromatosis and complete deafness. In this case, communication during the exercise programme was achieved using 25 cue cards that were prepared in advance and used to convey instructions. The patients' satisfaction was assessed using either of a simple three-item questionnaire (Case 1) or the Telemedicine Satisfaction Questionnaire with five additional items (Case 2).

In both cases, the exercise programme was successfully conducted, and the patients reported being highly satisfied with the programme.

Communication barriers can impede telerehabilitation therapy; this problem is aggravated when the recipients cannot receive on-site education for device operation and exercise performance in advance due to COVID-19 restrictions. However, the use of supplementary methodologies may contribute to solving these issues, further expanding the coverage and applicability of telerehabilitation.IMPLICATIONS FOR REHABILITATIONWe provided telerehabilitation for two patients with communication difficulties who were quarantined due to COVID-19.Telerehabilitation was carried out using a system with a remote-control mechanism to minimise patient input and avoid problems caused by their unfamiliarity in operating the devices.In addition, an online translation mechanism was used to overcome language differences, while cue cards were used for a patient with a hearing impairment.Telerehabilitation was performed without any technical issues. Both patients reported being highly satisfied with the intervention.This experience of providing telerehabilitation and overcoming communication difficulties may help develop a strategy to expand the coverage of telerehabilitation in the treatment of patients in isolation due to highly transmissible diseases, such as COVID-19.