The Catholic University of America


Telerehabilitation (telerehab) is the method of using technology to provide rehabilitation services at a distance. Through the appropriate application of technology, it is now possible to provide access to rehab services for clients who would otherwise be unable to receive them for reasons such as distance from a healthcare facility, lack of trained clinicians in a geographic area, or mobility impairments. Services can be provided to remote and underserved populations, resulting in improved quality of life, greater follow-up after discharge, and a prevention of secondary complications. These services can also be used by local clients preventing the need to make special trips to urban centers and allowing rehab clinicians to interact with clients more often.

Current Projects

Home-Based Automated Therapy of Arm Function after Stroke Via Telerehabilitation - We are working on development of a telerehabilitation-enabled automated system for providing Constraint-Induced Movement therapy. Enhanced Online Telerehabilitation System - We are developing a dynamic internet-based telemedicine system that will be applied across telerehabilitation activities at the National Rehabilitation Hospital (NRH).

Home-Based Automated Therapy of Arm Function after Stroke Via Telerehabilitation

In previous collaborative work between Peter Lum, Edward Taub and Gitendra Uswatte, a device for automating the delivery of Constraint Induced Movement Therapy (CIMT) was developed and tested for usability and effectiveness. The device, named AutoCITE, permits practice of 8 upper extremity tasks and provides frequent graphical performance feedback. The concept centers on the use of simple instrumented task devices and an intelligent automated algorithm for controlling the practice parameters. Two publications reported that AutoCITE was as effective as standard CIMT, while reducing therapist effort by 75%. A third report suggests that AutoCITE under simulated telerehabilitation conditions (i.e., patient and therapist were in different rooms in the lab) is also just as effective. In this study, we will modify AutoCITE so that it is more appropriate for use in patient's homes and evaluate its efficacy for providing CIMT on a telerehab basis. If successful, AutoCITE may evolve into an inexpensive means of remotely delivering a wide range of upper-extremity therapies.
PERSONNEL B. Gilmore, D. Brennan, and P. Lum
COLLABORATORS G. Uswatte and E. Taub (University of Alabama - Birmingham)

Enhanced Online Telerehabilitation System

Through past and ongoing research and development (NIH-NIBIB, 1 R21 EB003908-01A2) we have designed a customized computer-based telemedicine system that combines audio, video, and interactive data sharing (Figure 1). It was designed though a user-centered human factors approach that focused on user interface design. Specific to its targeted telerehabilitation population, emphasis was given to potential user impairments such as deficits in cognitive, gross or fine motor, visual, language or voice skills. The goal behind the system was to maximize a user?s abilities while minimizing the effect of any abilities that may have been lost or impaired.
This project will expand and build on the current system to add additional features and components so as to yield a more dynamic and powerful telemedicine platform that can be used by clinicians and researchers at the National Rehabilitation Hospital (NRH) and in other collaborating institutions. The system will include a web-enabled interface and client-server architecture, multi-site capability, and interactive data features.
FUNDING SOURCE Department of Defense