New UAlberta project helps people in rural communities access much-needed rehabilitation services

Rehab Robotics Lab study allows Albertans to heal at home by bringing specialized care to remote clinics via telehealth

Amanda Anderson - 24 February 2020

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.

This is something the University of Alberta's Rehabilitation Robotics Lab is trying to address with the help of telehealth technologies.

"Right now, many Albertans are at a disadvantage just because of where they live. Instead of being able to visit their local clinic or hospital, rural patients have to travel long distances on their own dime to access these same services," says Courtenay Badran, project coordinator in the Rehabilitation Robotics Lab, Faculty of Rehabilitation Medicine, University of Alberta. "Ideally, these individuals should be able to get the care they need in their own communities, so that they can comfortably heal at home."

Tele-Rehab 2.0, a newly established project in the 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.

For example, a patient in Grande Prairie with shoulder pain can see a physical therapist in Edmonton through Tele-Rehab 2.0, where they can have their measurements of pressure, mobility on the shoulder rotator cuff, and more given in real-time to the health-care professional. This system will not only allow for better access to care, but it will also provide opportunities for data collection to support the development of improved evidence-based clinical pathways.

"We're really working to address the inequality that rural patients face when accessing specialized health care while also supporting rural clinicians who often feel professionally isolated," explains Martin Ferguson-Pell, professor, Faculty of Rehabilitation Medicine and primary investigator on the project. "Our goal is to integrate existing technology, develop new technology and create protocols to allow for in-depth assessments without the specialist being in the room. We're changing how rehabilitation works in Alberta."

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.

"The current barriers that rural patients face when accessing rehabilitation services means that many patients go without therapy that could improve mobility, decrease pain and vastly improve their quality of life. If we make these services more accessible, it is very likely that more patients will receive the care they need in order to live healthier lives," says Badran.

The team is also working with local Alberta technology company Kinetisense to create special applications of their markerless motion capture program that will enable them to provide specialized assessments more efficiently.

"This technology will allow us to take measurements of someone by simply pointing a low-cost camera at them and then it will measure things like their range of motion, their sway, how balanced they are, how symmetrical they are and so on," says Ferguson-Pell, who is also producing an EMG device that will allow the team to measure push force (how hard the patient is pushing against the clinician) during assessments for shoulder, hip and knee injuries.

The project is currently working to recruit patients for trial runs in March 2020 with the help of remote clinicians. For Ferguson-Pell, the objective is to prove that rehabilitation can come in different formats, not just in person.

"We want to show that specialists can have confidence in remote assessments. In the end, we want our existing health-care services to adopt these practices to better serve our rural communities. We think this is going to move the bar and really help us to support these people."

This project was made possible thanks to support from the University of Alberta's SMART Network, Alberta Innovates and Pfizer.