Assessing balance via low-bandwidth Internet based telerehabilitation

Falls in the elderly population are a significant problem in Australia, accounting for the largest proportion of all injury-related deaths and hospitalizations. It is estimated that one in three older Australians will fall each year. Age related changes in balance and mobility are widely considered as one of the main factors contributing to falls in the elderly. A state-wide action plan initiated by the Queensland Government for falls prevention suggests that screening ‘at risk’ patients for risk factors and implementing treatment strategies such as exercise and balance programs, are good ways to reduce the incidence and associated costs of falls. However, providing screening and treatment services to rural and remote areas of Australia is problematic. This is due to a shortage of health care professional and specialists, inadequate and poorly distributed resources and the tyranny of distance.

Telemedicine, which is the use of various technologies to deliver health care services over a distance, has the potential to increase equity and access to health care services in these areas. Recent research by the applicant has demonstrated the efficacy of the use of this technology in the remote physiotherapy management of orthopaedic patients. Through the use of specially developed software, telemedicine may also provide a reliable method for screening patients who are at risk of falling and subsequently delivering tailored rehabilitation programs.

The specific aim of this project is to investigate whether it is possible to examine functional balance in the elderly person via a low-speed Internet-based telerehabilitation application. Participants recruited to the study will undergo a battery of balance assessments via two assessment methods: (1) in the traditional manner i.e. face-to-face with a physiotherapist and (2) via an Internet-based telerehabilitation application where the physiotherapist interacts with the patient remotely via personal computers and an Internet link. It is anticipated that the assessments performed via the telerehabilitation link will not differ significantly from those obtained in the traditional face-to-face manner. Comparable results between the two assessment methods will provide evidence for the further development of Internet-based assessment and treatment techniques for elderly persons who live in rural and remote areas of Australia and who are at risk of falling.