U of A robot rehab project hopes pandemic increases user comfort with virtual health care

Increased video-conferencing may boost willingness to book virtual appointments.

A demonstration at the University of Alberta rehabilitation robotics lab shows how a robot with a video screen allows a specialist to monitor patient movement from another location. Travis McEwan CBC

Travis McEwan, CBC News Edmonton August 13, 2020

A side-effect of the pandemic is an increased willingness to use technology. And researchers at the University of Alberta hope that will translate into an equal boost in the willingness of doctors and patients alike to try virtual health-care.

Months before the pandemic hit Edmonton in March, researchers at the U of A Rehabilitation Robotics Lab started a project called Tele-Rehabilitation 2.0.

Tele-Rehab 2.0, as it is dubbed, offered injured Albertans in Jasper, Grande Prairie and Peace River the opportunity to get a rehabilitation assessment done remotely by a clinician in an urban hub. It uses a variety of technology, including a video screen on a wheeled robot, that allows them to get a closer look at the injury and the movement.

It would save patients from driving for four hours or more to Edmonton. The larger implication would be a new way of providing service to about 24 per cent of Albertans who live in rural areas, according to the project website.

Initially, the team experienced a reluctance from both doctors and patients to participate, with in-person visits seen as an easier alternative.

Video quality and internet bandwidth were cited as easy outs for those without the patience to work through the new process.

The four areas of focus for the project are shoulder pain, hip and knee replacements, vertigo and balance and wheelchair special seating services. Patients will be provided with access to thorough assessments and communication with a specialist, as well as at-home exercises and individualized training programs thanks to telehealth technologies. Codie McLachlan, University of Alberta

“The patient may not be sufficiently tech-savvy to be able to make it work successfully. and so we can always talk ourselves out of doing things right,” said Martin Ferguson-Pell, a professor at the faculty of rehabilitative medicine.

“I think there was a certain amount of rationalizing why we shouldn’t do it,” he said. “What happened with COVID, we had to start rationalizing as to why we should.”

But after mid-March, physical distancing requirements and the shift for many Albertans to work from home forced them to get familiar with video-conferencing programs and become better at troubleshooting technical situations.

This has increased the rehab robotics team’s optimism about people’s willingness to participate in virtual health-care.

Earlier this week, a thunderstorm created reception issues during a virtual assessment. The team saw a resiliency that may have not existed before.

“The flexibility that the clinicians had was really incredible,” said Emily Armstrong, project co-ordinator for Tele-Rehabilitation 2.0.

“I think that a lot of that has come from the patience that everyone’s had to have because of COVID, just trying to make it work because this is the only way we can do this stuff.”

The project has assisted four patients with assessments so far and the team plans to do more until November before its funding ends in December.

About the author
Travis McEwan is a video journalist who has not won any awards. Originally from Churchill, Man., he’s spent the last decade working at CBC Edmonton. Email story ideas to travis.mcewan@cbc.ca

Source CBC News Edmonton


UAlberta’s Tele-Rehab 2.0: Helping people in rural communities heal at home. About 24 per cent of Albertans live outside of the major cities. That means about one million people don’t have access to specialized rehabilitation services in their own communities. Tele-Rehab 2.0, a newly established project in the University of Alberta’s Rehabilitation Robotics Lab, is breaking down health-care barriers in rural communities by using technology to mediate communication between remote patients and the clinicians and urban specialists who treat them. Video: Nathan Martin. RehabMedicineUofA Youtube Feb 24, 2020
  Further reading

Improving osteoarthritis care by digital means – Effects of a digital self-management program after 24- or 48-weeks of treatment, Dahlberg LE, Dell’Isola A, Lohmander LS, Nero H. PLoS One. 2020 Mar 4;15(3):e0229783. doi: 10.1371/journal.pone.0229783. PMID: 32130276; PMCID: PMC7056265. Full text

Exercise interventions and patient beliefs for people with hip, knee or hip and knee osteoarthritis: a mixed methods review, Hurley M, Dickson K, Hallett R, Grant R, Hauari H, Walsh N, Stansfield C, Oliver S. Cochrane Database Syst Rev. 2018 Apr 17;4(4):CD010842. doi: 10.1002/14651858.CD010842.pub2. Full text

Are exercise interventions beneficial for people with hip and knee osteoarthritis? – A Cochrane Review summary with commentary, Ilieva EM. Musculoskelet Sci Pract. 2019 Dec;44:102041. doi: 10.1016/j.msksp.2019.07.005. Epub 2019 Jul 20. Full text

An algorithm recommendation for the management of knee osteoarthritis in Europe and internationally: a report from a task force of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO), Bruyère O, Cooper C, Pelletier JP, Branco J, Luisa Brandi M, Guillemin F, Hochberg MC, Kanis JA, Kvien TK, Martel-Pelletier J, Rizzoli R, Silverman S, Reginster JY. Semin Arthritis Rheum. 2014 Dec;44(3):253-63. doi: 10.1016/j.semarthrit.2014.05.014. Epub 2014 May 14. PMID: 24953861.

Also see
New UAlberta project helps people in rural communities access much-needed rehabilitation services University of Alberta
Pilot program uses robotics, internet to deliver rehab care to rural Albertans CBC
Tele-rehabilitation for people living with multiple sclerosis Murdoch University
Major savings possible with app-based osteoarthritis treatment Lund University

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