International Journal of Telerehabilitation <p>The International Journal of Telerehabilitation (IJT) is a biannual journal dedicated to advancing telerehabilitation by disseminating information about current research and practices.</p> <p>IJT accepts original research, systematic reviews on novel topics, case studies, viewpoints, technology reviews, book reviews, and country reports that detail the status of telerehabilitation. IJT accepts manuscript submissions between January 5<sup>th</sup> – March 31<sup>st</sup> for the Spring issue and July 1<sup>st</sup> – September 30<sup>th</sup> for the Fall issue.&nbsp; All manuscripts receive a first-level review by Editorial Board members.&nbsp; Results of the first-level review are shared with authors immediately upon review completion.&nbsp; Manuscripts receiving favorable first-level reviews are sent for blinded second-level reviews to reviewers (Editorial Board members, Section Editors, and/or invited reviewers with expertise in the subject matter).&nbsp; Authors are notified of second-level review results for the Spring issue in April, and in October for the Fall issue.&nbsp; The Spring issue of IJT is published in June and the Fall issue of IJT is published in December of each year.&nbsp;</p> University Library System, University of Pittsburgh en-US International Journal of Telerehabilitation 1945-2020 <p>Authors who publish with this journal agree to the following terms:</p><ol><li>The Author retains copyright in the Work, where the term “Work” shall include all digital objects that may result in subsequent electronic publication or distribution.</li><li>Upon acceptance of the Work, the author shall grant to the Publisher the right of first publication of the Work.</li><li>The Author shall grant to the Publisher and its agents the nonexclusive perpetual right and license to publish, archive, and make accessible the Work in whole or in part in all forms of media now or hereafter known under a <a title="CC-BY" href="">Creative Commons Attribution 4.0 International License</a> or its equivalent, which, for the avoidance of doubt, allows others to copy, distribute, and transmit the Work under the following conditions:<ol type="a"><li>Attribution—other users must attribute the Work in the manner specified by the author as indicated on the journal Web site;</li></ol>with the understanding that the above condition can be waived with permission from the Author and that where the Work or any of its elements is in the public domain under applicable law, that status is in no way affected by the license.</li><li>The Author is able to enter into separate, additional contractual arrangements for the nonexclusive distribution of the journal's published version of the Work (e.g., post it to an institutional repository or publish it in a book), as long as there is provided in the document an acknowledgement of its initial publication in this journal.</li><li>Authors are permitted and encouraged to post online a prepublication manuscript (but not the Publisher’s final formatted PDF version of the Work) in institutional repositories or on their Websites prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work. 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Revision Description: Removed outdated link. </span></p> Editors' Note <p>.</p> Ellen R. Cohn Jana Cason Copyright (c) 2021 Ellen R. Cohn, Jana Cason 2021-12-01 2021-12-01 13 2 10.5195/ijt.2021.6440 Best Practices for Building Interprofessional Telehealth: Report of a Conference <div> <p class="MDPI17abstract">The Arizona Biomedical Research Centre (ABRC) has funded a series of workshops and conferences since 2016 to build the capacity of local, tribal, and state agencies, healthcare delivery organizations, and non-governmental organizations to engage in meaningful research related to health disparities. With the COVID-19 pandemic, the use of telehealth has dramatically increased, particularly in nursing, occupational therapy (OT), physical therapy (PT), and speech-language pathology (SLP). The purpose of this paper is to summarize the presentations and discussion from the conference titled “Telerehabilitation and Telepractice: An Interprofessional Conference to Build Connections and Best Practices,” held remotely on March 4-5, 2021. Terminology and concepts from the conference were debated, modified, and refined, based on an interprofessional audience. Presenters at the conference, all leaders in their field, discussed the current status of telehealth in their professions, including best practices, challenges, future trends, and research needs.</p> </div> Lynda B. Ransdell M. Elizabeth Greenberg Emi Isaki Alan Lee Janet P. Bettger Goris Hung Amy Gelatt Ambur Lindstrom-Mette Jana Cason Copyright (c) 2021 Lynda B. Ransdell, M. Elizabeth Greenberg, Emi Isaki, Alan Lee, Janet P. Bettger, Goris Hung, Amy Gelatt, Ambur Lindstrom-Mette, Jana Cason 2021-12-01 2021-12-01 13 2 10.5195/ijt.2021.6434 Telerehabilitation Policy Report: Interprofessional Policy Principles and Priorities <p>The American Occupational Therapy Association, the American Physical Therapy Association, the American Speech-Language-Hearing Association and the American Telemedicine Association are collaborating to advance telehealth and ensure sustainability of virtual care services beyond the COVID-19 pandemic. These professional associations represent the interests of more than 888,000 rehabilitation services professionals. This paper summarizes the current state of telehealth policy principles and priorities for rehabilitation services. The report outlines key considerations when advocating with policymakers to avoid the “Telehealth Cliff” for audiology and therapy services and to facilitate the continued advancement of telehealth innovation and transformation by rehabilitation services professionals.</p> Evelyn Abrahante Terrell Andy Bopp Kristen Neville David Scala Kyle Zebley Copyright (c) 2021 Evelyn Terrell, Andy Bopp, Kristen Neville, David Scala, Kyle Zebley 2021-12-01 2021-12-01 13 2 10.5195/ijt.2021.6433 Case Managers’ Perceptions About Synchronous Telerehabilitation versus Clinic-based Physical Therapy Services for People with Spinal Cord Injury <p>People with spinal cord injury (SCI) require extensive rehabilitation to maximize independence and quality of life. Much of this treatment occurs on an outpatient basis through telerehabilitation or clinic-based services. Synchronous telerehabilitation has become increasingly common in recent years, but many professionals remain reluctant to suggest it when clinic-based services are available. This survey study explored case managers’ perceptions regarding advantages and disadvantages of synchronous telerehabilitation versus clinic-based physical therapy services for people with SCI. Respondents were 89 case managers responsible for service provision coordination. Results showed a significant preference for clinic-based rather than telerehabilitation physical therapy services. Relative experience with the two service delivery models significantly affected perceptions. Only facilitating travel convenience differed significantly as a reason for recommending one service delivery method over the other. The incongruity between perceptions about synchronous telerehabilitation and existing literature about its cost, convenience, and efficacy suggests a need for additional education.</p> Steve Kerschke Karen Hux Copyright (c) 2021 Karen Hux, Steve Kerschke 2021-12-01 2021-12-01 13 2 10.5195/ijt.2021.6392 The Effectiveness of Exercise Interventions Supported by Telerehabilitation For Recently Hospitalized Adult Medical Patients: A Systematic Review <p>Objective: To evaluate the effectiveness of exercise interventions delivered via telerehabilitation (via videoconference) for recently hospitalized adult medical patients. Data sources: A search was undertaken across six databases for English language publications from inception to May 2020. Methods: Studies were selected if they included an exercise intervention for recently hospitalized adults, delivered by a physiotherapist via videoconference. Two reviewers independently screened 1,122 articles (21 full text screening) and assessed methodological quality using the Downs and Black Checklist. A narrative synthesis of the included studies was undertaken. Results: Three studies met eligibility criteria involving 201 participants with chronic heart failure or chronic obstructive pulmonary disease. Findings demonstrated limited evidence supporting the effectiveness of exercise delivered via telerehabilitation in improving physical function and patient reported quality of life outcomes in recently hospitalized medical patients. Telerehabilitation in this setting was also associated with high attendance rates and patient satisfaction. Conclusions: Findings provide preliminary support for the benefits of exercise interventions delivered via telerehabilitation for recently hospitalized medical patients. Results do need to be interpreted with caution as further high-quality studies specific to this method of exercise intervention delivery are needed.</p> Simone Leslie Junmin Tan Prudence J. McRae Shaun P. O'Leary Julie A. Adsett Copyright (c) 2021 Simone Leslie, Junmin Tan, Prudence J. Mcrae, Shaun P. O’leary, Julie A. Adsett 2021-12-15 2021-12-15 13 2 10.5195/ijt.2021.6356 Telerehabilitation is Effective to Recover Functionality and Increase Skeletal Muscle Mass Index in COVID-19 Survivors <p>Objective: The purpose of this study was to evaluate the effects of a telerehabilitation program for COVID-19 survivors on their functionality, aerobic capacity, upper-lower body strength and skeletal muscle mass index. Methods: Fifty patients (22 M); age 54.1±15.4 who became ill with COVID-19 during 2020 completed a 24-session telerehabilitation program. The following measures were taken: Barthel’s index, two minutes step test (2MST), elbow flexion one-repetition maximal (1RM), short physical performance battery (SPPB), hand grip strength, 30-second chair stand, skeletal muscle index (SMI), body fat percentage, resting pulse, arterial blood pressure, and pulse oximetry. Results: There was a significant increase in the Barthel index (p?0.0001), 2MST (p?0.0001), 1RM elbow flexion (p?0.0001), SPPB (p?0.0001), hand grip strength (p?0.0001), 30-second chair stand (p?0.0001), and SMI (p?0.0001). Conclusion: A 24 session in-home telerehabilitation program promoted the recovery of physical independence and increases in skeletal muscle mass index and physical fitness.</p> Jorge Cancino-López Patricio Zarricueta Vergara Bárbara Leyton Dinamarca Pedro Figueroa Contreras Luis Miño Cárcamo, Nicolás Cartagena Ibarra Johana Soto-Sánchez Copyright (c) 2021 Jorge Cancino-López, Patricio Zarricueta Vergara, Bárbara Leyton Dinamarca, Pedro Figueroa Contreras, Luis Miño Cárcamo, , Nicolás Cartagena Ibarra, Johana Soto-Sánchez 2021-12-08 2021-12-08 13 2 10.5195/ijt.2021.6415 Feasibility and Acceptability of a Real-Time Telerehabilitation Intervention for Children and Young Adults with Acquired Brain Injury During the COVID-19 Pandemic: An Experience Report <p>This study examined the feasibility and acceptability of a telerehabilitation intervention during the COVID-19 pandemic in a sample of children and young adults with Acquired Brain Injury (ABI). Thirteen patients and/or their families agreed to participate in the speech and neuropsychological telerehabilitation sessions. The treatment was synchronous, patient centered and aimed at improving specific abilities. Sessions were held twice a week over a 10-week period. Two questionnaires were completed both by parents and therapists to assess feasibility and acceptability. Neither technical issues nor clinical obstacles were found. The quality of the therapeutic relationship played a key role in the intervention. Synchronous telerehabilitation provided several advantages both for patients and therapists. Moreover, the patient centered intervention eased the burden of the caregivers at a time of high stress. The real-time telerehabilitation treatments were deemed suitable for children and young adults with ABI. Further studies are needed to support the use of telerehabilitation as an integral part of their standard care.</p> Maria Chiara Oprandi Alessandra Bardoni Luisa Corno Agata Marchetti Guerrini Luigi Molatore Luisella Negri Elena Beretta Federica Locatelli Sandra Strazzer Geraldina Poggi Copyright (c) 2021 Maria Chiara Oprandi, Alessandra Bardoni, Luisa Corno, Agata Marchetti Guerrini, Luigi Molatore, Elena Beretta, Federica Locatelli, Sandra Strazzer, Geraldina Poggi 2021-12-01 2021-12-01 13 2 10.5195/ijt.2021.6423 The Evolution of Telehealth From Pre-COVID-19 Pandemic Through A Hybrid Virtual Care Delivery Model: A Pediatric Hospital’s Journey <p>The COVID-19 pandemic transformed care delivery and influenced telehealth adoption by rehabilitation professionals and their patients. The purpose of this paper is to describe a pediatric health system’s telehealth services pre-pandemic and how those services were scaled during the pandemic. A secondary aim is to provide a roadmap for the operational delivery of telehealth and rehabilitation services, including transition to a hybrid care delivery model. Findings suggested that telehealth can be rapidly scaled to address patient healthcare needs for an early intervention population during a pandemic. Telehealth use during the pandemic helped ensure continuity of care and likely reduced the risk of exposure to patients and staff to the virus. Benefits included enhanced access to care, and savings in time and money for families. Interestingly, as the pandemic declined, the use of telehealth services declined due to patient preference, with many families opting to request a return to in-person care.</p> <p>&nbsp;</p> Evelyn Abrahante Terrell Saima Aftab Anne Babitz Lauren Butler Nicole Gondar Hernandez Bianca Hornik Keysla Lee Jennifer Perez Elizabeth Sotolongo Jessica Thomas Copyright (c) 2021 Evelyn Terrell, Saima Aftab, Anne Babitz, Lauren Butler, Bianca Hornik, Nicole Hernandez, Keysla Lee, Jennifer Perez, Elizabeth Sotolongo, Jessica Thomas 2021-12-01 2021-12-01 13 2 10.5195/ijt.2021.6432 Telehealth Use By Persons with Disabilities During the COVID-19 Pandemic <p>Telehealth use rapidly expanded during the COVID-19 pandemic. Understanding if, and how, people from disabilities used telehealth during the pandemic is vital to assuring this evolving and increasingly common form of health care is equitably developed and delivered to avoid reproducing the health disparities people with disabilities already face. Our aim was to explore the use of telehealth among people with disabilities during the pandemic. We conducted a weighted secondary analysis of United States Census Bureau data (April-July 2021) from 38,512 (unweighted) people with disabilities. Our findings revealed 39.8% of people with disabilities used telehealth during the second year of the pandemic, ranging from 34.5% of people with hearing disabilities to 43.3% of people with mobility disabilities. There were also differences in telehealth use based on sociodemographics. Telehealth promises to open doors to more equitable health care access for many people with disabilities, but only if access barriers are removed.</p> Carli Friedman Laura VanPuymbrouck Copyright (c) 2021 Carli Friedman, Laura VanPuymbrouck 2021-12-01 2021-12-01 13 2 10.5195/ijt.2021.6402 Telerehabilitation in the Middle East North Africa Region: A Structured Review <p class="AbstractBodyText">A structured review using the PRISMA guidelines, MeSH keywords and eight health databases was conducted (1990 to March 2021). Telerehabilitation research evidence from the Middle East and North Africa region (MENA) was summarized. Twelve studies from Iran, Israel, Morocco, and Saudi Arabia met inclusion criteria; nearly all had been published within the past five years. Methodological quality was moderate to good in the four randomized controlled trials, five cohort-studies and three cross-section surveys. There were seven intervention studies in cardiovascular, musculoskeletal, neurology or burn rehabilitation and three patient perception and two practitioner perception studies. Narrative synthesis revealed content themes relating to rehabilitation availability and accessibility; patient/practitioner perceptions of telerehabilitation; telerehabilitation to augment traditional services; and barriers to telerehabilitation. Telerehabilitation practice in MENA has been demonstrated as feasible, acceptable to patients, and effective in practitioner-designed cohort specific programs. Practitioners are generally positive but lack experience and need training, enabling technological systems, and policy frameworks.</p> <p>&nbsp;</p> Naif Qasam Aljabri Kim Bulkeley Anne Cusick Copyright (c) 2021 Naif Qasam Aljabri, Kim Bulkeley, Anne Cusick 2021-12-01 2021-12-01 13 2 10.5195/ijt.2021.6401 Perceptions and Willingness of Physiotherapists in India to Use Telerehabilitation During the COVID-19 Pandemic <p>The COVID-19 pandemic and ensuing lockdowns have restricted regular clinical physiotherapy services. This has necessitated a sudden shift to the use of telerehabilitation to prevent disruption in the delivery of physiotherapy interventions. This survey investigates the perceptions of physiotherapists in India and their willingness to use telerehabilitation during the pandemic. An electronic questionnaire was sent to 176 physiotherapists around India, and 118 completed questionnaires were received (acceptance rate of 67.04%). A majority of the respondents (n=67; 77%) had used telerehabilitation for the first time during the pandemic, and 72.9% (n=86) found telerehabilitation to be a viable option for healthcare delivery during the pandemic. Some of the barriers identified were lack of training (n=64; 52%) and a lack of connection between information and communication technology experts and clinicians (n=62; 52.5%). Overall, physiotherapists in India expressed a positive perception of telerehabilitation and are willing to use such services.</p> Arnold Fredrick D'Souza Sydney Roshan Rebello Copyright (c) 2021 Arnold Fredrick D'Souza, Sydney Roshan Rebello 2021-12-01 2021-12-01 13 2 10.5195/ijt.2021.6425 Commonly Used Outcome Measurement Tools in Pediatric Physical Therapy Telerehabilitation in the Philippines: A Quantitative Cross-Sectional Descriptive Study <p>With the COVID-19 pandemic, the adoption of telerehabilitation has rapidly increased to improve access and minimize cross-infection risk to patients. Nevertheless, Filipino pediatric physical therapists (PTs) must ensure that they conduct evidence-based procedures for specific tests and measures to determine patient outcomes. This investigation reported the most common pediatric outcome measurement tools (OMTs) used in telerehabilitation by Filipino pediatric PTs treating 0 to 21-year-olds in the Philippines. Validation and pilot testing of an adapted questionnaire on OMT usage was undertaken before dissemination via email and social media. Pediatric PTs reported that the commonly used OMTs in telerehabilitation are Gross Motor Function Measure (GMFM) (100%)—including both versions of GMFM-88 and GMFM-66 followed by Pediatric Balance Scale (PBS) (30%). These findings support the use of feasible OMTs in pediatric telerehabilitation due to their applicability in the online setting.</p> Arlene Chiong Maya Therese Daniela Manaloto Christian Rimando Maria Eliza Dela Cruz Daniel Stephen Banting Alliana Cielo Equipaje Noel Antonio Ipo Jana Mae Mosi Ramos Marc Jefferson Rillas Jaycelle Anne Tajan Copyright (c) 2021 Arlene Chiong Maya, Therese Daniela Manaloto, Christian Rey Rimando, Maria Eliza Dela Cruz, Daniel Stephen Banting, Aliana Cielo Equipaje, Noel Antonio Ipo, Jana Mae Mosi Ramos, Marc Jefferson Rillas, Jaycelle Anne Tajan 2021-12-17 2021-12-17 13 2 10.5195/ijt.2021.6427