[PD Test]Home-based rehabilitation technologies gain ground

Innovations in home-based rehabilitation technologies are gaining popularity now as alternative solutions to providing health care services to an aging population are being sought. One such innovation is telerehabilitation or the practice of providing rehabilitation services over a distance through the use of information and communications technology such as the Internet. Consultative, preventive, diagnostic and therapeutic services are provided to patients via two-way interactive telecommunication technology.

“There is a paradigm shift in healthcare. The consumer now is at the center of the orbit of various healthcare strategies. Health providers or doctors are not anymore the center of healthcare system. Therefore, we need a new approach,” said Dr. Nam Jong Paik, a telerehabilitation expert from Seoul National University, Bundang Hospital.

In Korea, patient co-payment was around US$600 in 2008. However, since medical care is given free to citizens, the trends show that people, especially the elderly, tend to overuse the available health services. As such, there is a clear need for an alternative approach to clinic-based and healthcare provider-centred health services delivery system.

“With limited resources and experienced people we still need increased productivity without sacrificing quality. Healthcare system shifts from recovery from illness to maintaining wellness. The focus is on fully individualized and mobile concern, getting support people at home or in care facilities to improve the delivery of health and social care,” said Paik as he explained the need for telemedicine and telerehabilitation.

As technology advances in the field of remote sensing and the cost of broadband technology goes down, opportunities to do telerehabilitation and telemedicine in general are ripe for the picking, according to Paik. Telerehabilitation overcomes the distance barrier and the insufficient number of skilled health workers. It fills the need to decongest hospitals, maximizing limited resources to serve a greater number of people. With it, patients can be discharged earlier and be monitored continuously for care and follow-up.

Telerehabilitation can be applied in various aspects of healthcare such as consultation, home and activity monitoring, assessment, motor relearning via robot and biofeedback, diagnosis and evaluation, and education and training. Remote Speech-language and Cognitive Treatment or RESPECT, developed in the US, helps patients to do speech therapy remotely.

Virtual reality has been used for gait-rehabilitation for post-stroke patients, cognitive training and neglect training. Paik and his colleagues have developed a game of catch-the-rabbit using mobile phones and tablet to rehabilitate stroke patients through exercises and movements that are simulated by the game.

While Paik is optimistic about the advantages of telerehabilitation, he also pointed out that a Cochrane review emphasized the need for more studies on telemedicine applications to clearly establish its benefits.