Telerehabilitation: An Alternative Service Delivery Model for Pediatric Neurorehabilitation Services at a Tertiary Care Center in India

Abstract

Background: Neurorehabilitation is facing a unique challenge as COVID-19 circumstances magnify the access and resource barrier in healthcare provision; and are causing disruption in the continuity of care of children with disability. An affirmative action is required as a ‘Disability-inclusive response to the COVID-19 crisis.’ This study thus aimed to determine if Telerehabilitation (TR) model of service delivery is a feasible and effective alternative for pediatric neurophysiotherapy. Methodology: This is a clinical trial conducted on children diagnosed with developmental delay or neurological condition and referred for Physiotherapy at a tertiary care center. Clinical consultation was provided remotely with the use of real time interactive technology. Outcome indicators used were: 1)Timely receipt of physiotherapy services; 2) Child’s clinical outcomes; and 3) Familiy’s acceptability and satisfaction with the provision of TR. Results: With regards to feasibility, the most common issues faced during TR sessions were technical; lack of time with mother; child’s medical illness, etc. Children’s clinical outcomes showed improvement reported as ‘acquisition of developmental skills’ and ‘the use of appropriate functional behaviors to meet their needs’. Families showed satisfaction with TR services however, expressed the need for in-person sessions. Conclusion: In the current scenario, TR may enhance the capacity of families to meet the needs of their child with a disability by connecting them with health care providers, resources and supports; thus ensuring continuity of care. While guidelines to tackle this unprecedented situation continue to develop, TR demonstrates the potential as an alternative rehabilitation strategy thereby ameliorating the impact of social distancing on underprivileged children. However, some psychosocial factors act as barriers to feasibility of TR in pediatric population.