Telerehabilitation: current perspectives.

Telerehabilitation in which rehabilitation services are provided at a distance using communication technologies is a new and developing field of telehealth. Primarily developed to provide equitable access to individuals who are geographically remote and to those who are physically and economically disadvantaged, telerehabilitation also has the capacity to improve the quality of rehabilitation health care. Online delivery of rehabilitation enables the rehabilitation therapist to optimize the timing, intensity and duration of therapy that is often not possible within the constraints of face-to-face treatment protocols in current health systems. This chapter outlines the advances made to date in telerehabilitation applications in the fields of physiotherapy, speech-language pathology, occupational therapy, and biomedical engineering and provides evidence for the success of these applications. Applications to date encompass systems ranging from low-bandwidth low-cost videophones, to highly expensive, fully immersive virtual reality systems with haptic interfaces. A number of barriers to the establishment and advancement of telerehabilitation within health care systems have been outlined and include professional issues relating to the inherent hands-on approach of some treatments, licensure laws, professional skill development, patient disability, reimbursement, and the paucity of online assessment and treatment tools and outcomes data. In response, possible solutions to these barriers such as the development and validation of alternative assessment and treatment procedures, involvement in the international policy debate, as well as the resolution of national professional policies which hinder the wider uptake of telerehabilitation technologies, have been outlined. The future of telerehabilitation is promising as a new, yet complex form of telehealth with the capacity to provide a wide range of services specifically designed to suit the needs of the individual.