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Dec. 21, 2020

Two recent studies published in the International Journal of Telerehabilitation show that telehealth can be effective in providing Complex Rehabilitation Technology (CRT) to Veterans, including custom-designed and custom-fitted manual and power wheelchairs.

The research was conducted by investigators at the Human Engineering Research Laboratories (HERL) and our Rehabilitation Science and Technology Department. HERL is a partnership between VA Pittsburgh Healthcare System, the University of Pittsburgh and UPMC.

The first study involved a cohort of Veterans with disabilities who were assessed by a therapist through telehealth at their homes for CRT and then compared to a matched sample of non-Veterans who were assessed through traditional in-person methods. Pre and post scores on the Functional Mobility Assessment questionnaire found similar outcomes.

The second study found Veterans and providers were satisfied with using telehealth for their CRT needs and that Veterans often preferred telehealth. 

“Providing properly fitted mobility equipment is a consumer-centered process that involves several steps, interdisciplinary communication, and assessment of the person’s natural living situation,” said Dr. Brad Dicianno, study investigator and HERL medical director. “Regardless of the current pandemic, for people with disabilities, accessing appropriate services can be a challenge, especially given limited mobility, medical conditions that prevent travel, equipment that is in disrepair, or inaccessible transportation.”

One advance resulting from the COVID-19 pandemic is expanded remote health care services. This is especially significant for people in high-risk groups, said Dicianno, who is also an associate professor in the university’s Physical Medicine and Rehabilitation department. People with severe disabilities depend on CRT, he said, not only to meet medical needs but to function and participate in their communities.

“These results are consistent with our earlier studies with non-Veterans and support the use of telehealth strategies as an option for all CRT users. When applied appropriately, telehealth can complement traditional in-person procedures and in some cases, replace them,” said Mark Schmeler, an associate professor with the Rehabilitation Science and Technology department.

“Veterans Affairs is recognized as a world leader in terms of development and deployment of telehealth services and is a perfect setting for testing innovative models of care,” Dicianno said. “These publications show that we can use telerehabilitation to assess and provide wheelchairs to Veterans in their homes in rural communities.”

The findings provide further understanding to the benefits of telehealth for CRT and can serve as evidence to support continued investigation and use of these methods beyond the current public health emergency, Schmeler noted. 

“I have personally noted more meaningful information when I can observe a person engaged in mobility-related activities of daily living in their natural environment versus what is assessed in a clinical setting,” said Schmeler, who is a practicing occupational therapist and certified assistive technology professional.

The research was funded through the MyVA Access Improvement Project, a VA partnership between its Office of the Under Secretary for Health and Office of Rural Health partnership.

Media interested in interviewing study investigators may contact Sheila Tunney, public affairs specialist, at Sheila.tunney@va.gov or 412-360-1479.

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About VA Pittsburgh Healthcare System

VA Pittsburgh Healthcare System is one of the largest and most progressive VA health care systems in the nation. More than 3,400 employees serve approximately 80,000 Veterans every year, providing a range of services from transplant medicine to primary care. It is also a center of research and learning, with more than $30 million in research projects and a robust training program for residents and students. The system is a leader in virtual care delivery through telemedicine. Medical centers are in Oakland and O’Hara Township.  Outpatient clinics are in Beaver, Fayette, Washington and Westmoreland counties in Pennsylvania and Belmont County in Ohio. Veterans can check on their eligibility and enrollment by calling 412-822-2040. Visit pittsburgh.va.gov and facebook.com/vaphs.

About the Human Engineering Research Laboratories (HERL)

The Human Engineering Research Laboratories (HERL) has been at the forefront of assistive technology research for more than 25 years. A collaboration between VA Pittsburgh Healthcare System, the University of Pittsburgh, and the UPMC Health System, HERL is dedicated to wheelchair and mobility research, specifically by improving the mobility and function of veterans and all people with disabilities through advanced engineering in clinical research and medical rehabilitation on local, national, and international levels. Using state-of-the-art laboratories and research instruments, HERL also studies robotics in assistive technology, athletics in rehabilitation, assistive living spaces, wheelchair transfer efficiency, clinician training, and force and vibration on wheelchair users.