Schein Richard M, Schmeler Mark R, Brienza David, Saptono Andi, Parmanto Bambang
Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, Pennsylvania 15203, USA.
Telemed J E Health. 2008 Nov;14(9):932-8. doi: 10.1089/tmj.2008.0010.
The purpose of this paper is to explain the development, methodology, and implementation of an assistive technology (AT) service delivery protocol using a telerehabilitation consultation model for evaluation of remote wheelchair prescriptions. The provision of wheeled mobility and seating interventions can be complex when considering people with intricate seating and positioning needs, environmental factors, and wide array of product interventions. The availability of qualified practitioners with specialty expertise in this area is limited, especially outside of urban areas. Therefore, people are potentially isolated from rehabilitation services due to geography or physical limitations. A repeated measure study design is used to evaluate the service delivery protocol measured by the effectiveness of wheeled mobility and seating interventions provided in a remote location by a generalist occupational and/or physical therapy practitioner with consultation from an expert therapist via interactive teleconferencing. Effectiveness is measured by magnitude of change and scored by pre and post scores of the Functioning Everyday with a Wheelchair (FEW) outcome measure tool. Two model programs have been specified and are currently implementing the service delivery protocol. The live interaction has enabled remote therapists the ability to exchange personal and health information to experts in the field from an urban facility. The impact of this service delivery protocol will be augmented as it is to be launched and replicated in three additional sites. Telerehabilitation is a new field that can only be measured by its long-term impact; however, its success can be looked at by its development and implementation into everyday clinical service delivery.
本文旨在解释一种辅助技术（AT）服务提供协议的开发、方法和实施情况，该协议采用远程康复咨询模型来评估远程轮椅处方。当考虑到有复杂座位和体位需求的人群、环境因素以及大量的产品干预措施时，提供轮式移动和座位干预可能会很复杂。在这一领域拥有专业专长的合格从业者数量有限，尤其是在城市地区以外。因此，人们可能会因地理位置或身体限制而无法获得康复服务。本研究采用重复测量研究设计，通过一名通科职业和/或物理治疗师在专家治疗师通过交互式电话会议提供咨询的情况下，在远程地点提供的轮式移动和座位干预的有效性来评估服务提供协议。有效性通过变化幅度来衡量，并通过轮椅日常功能（FEW）结果测量工具的前后得分进行评分。已经指定了两个示范项目，目前正在实施该服务提供协议。实时互动使远程治疗师能够与城市机构的该领域专家交流个人和健康信息。随着该服务提供协议将在另外三个地点推出和复制，其影响将得到增强。远程康复是一个新领域，只能通过其长期影响来衡量；然而，它的成功可以通过其在日常临床服务提供中的发展和实施来评判。
