Research Article
No access
Published Online: 1 August 2016

Conditions of Use, Reliability, and Quality of Audio/Video-Mediated Communications During In-Home Rehabilitation Teletreatment for Postknee Arthroplasty

Publication: Telemedicine and e-Health
Volume 22, Issue Number 8


Background: Audio/video-mediated communication between patients and clinicians using videoconferencing over telecommunication networks is a key component of providing teletreatments in rehabilitation. Objective: The objectives of this study were to (1) document the conditions of use, performance, and reliability of videoconferencing-based communication in the context of in-home teletreatment (TELE) following total knee arthroplasty (TKA) and (2) assess from the perspective of the providers, the quality attributes of the technology used and its impact on clinical objectives. Materials and Methods: Descriptive embedded study in a randomized controlled trial using a sample of 97 post-TKA patients, who received a total of 1,431 TELE sessions. Technical support use, service delivery reliability, performance, and use of network connection were assessed using self-report data from a costing grid and automated logs captured from videoconferencing systems. Physical therapists assessed the quality and impact of video-mediated communications after each TELE session on seven attributes. Results: Installation of a new Internet connection was required in 75% of the participants and average technician's time to install test and uninstall technology (including travel time) was 308.4 min. The reliability of service delivery was 96.5% of planned sessions with 21% of TELE session requiring a reconnection during the session. Remote technical support was solicited in 43% of the sessions (interventions were less than 3-min duration). Perceived technological impacts on video-mediated communications were minimal with quality of the overall technical environment evaluated as good or acceptable in 96% of the sessions and clinical objectives reached almost completely or completely in 99% of the sessions. Conclusions: In-home rehabilitation teletreatments can be delivered reliably but requires access to technical support for the initial setup and maintenance. Optimization of the processes of reliably connecting patients to the Internet, getting the telerehabilitation platform in the patient's home, installing, configuring, and testing will be needed to generalize this approach of service delivery.

Get full access to this article

View all available purchase options and get full access to this article.


OECD. Hip and knee replacement in health at a glance: 2013. OECD Indicators. 2013;. (last accessed February 28, 2016).
Hailey D, Roine R, Ohinmaa A, Dennett L. Evidence of benefit from telerehabilitation in routine care: A systematic review. J Telemed Telecare 2011;17:281–287.
Kairy D, Lehoux P, Vincent C, Visintin M. A systematic review of clinical outcomes, clinical process, healthcare utilization and costs associated with telerehabilitation. Disabil Rehabil 2009;31:427–447.
Brennan DM, Mawson S, Brownsell S. Telerehabilitation: Enabling the remote delivery of healthcare, rehabilitation, and self management. Stud Health Technol Inform 2009;145:231–248.
McCue M, Fairman A, Pramuka M. Enhancing quality of life through telerehabilitation. Phys Med Rehabil Clin N Am 2010;21:195–205.
Russell TG. Physical rehabilitation using telemedicine. J Telemed Telecare 2007;13:217–220.
Winters JM. Telerehabilitation research: Emerging opportunities. Annu Rev Biomed Eng 2002;4:287–320.
Fatehi F, Armfield NR, Dimitrijevic M, Gray LC. Clinical applications of videoconferencing: A scoping review of the literature for the period 2002–2012. J Telemed Telecare 2014;20:377–383.
Abran A, Khelifi A, Suryn W. Usability meanings and interpretations in iso standards. Softw Qual J 2003;1:323–336.
Demiris G, Oliver DP, Wittenberg-Lyles E, Washington K. Video-mediated communication in hospice interdisciplinary team meetings: Examining technical quality and content. AMIA Annu Symp Proc 2009;2009:135–139.
Demiris G, Parker Oliver D, Kruse RL, Wittenberg-Lyles E. Telehealth group interactions in the hospice setting: Assessing technical quality across platforms. Telemed J E Health 2013;19:235–240.
Demiris G, Speedie S, Finkelstein S, Harris I. Communication patterns and technical quality of virtual visits in home care. J Telemed Telecare 2003;9:210–215.
LeRouge C, Garfield MJ, Hevner AR. Quality attributes in telemedicine video conferencing. HICSS-35’02 35th Hawaii International Conference on System Sciences, 2002.
LeRouge CM, Garfield MJ, Hevner AR. Patient perspectives of telemedicine quality. Patient Prefer Adherence 2015;9:25–40.
Moffet H, Tousignant M, Nadeau S, Mérette C, Boissy P, Corriveau C, et al. Evidence of the non-inferiority of in-home telerehabilitation compared to face-to-face rehabilitation after total knee arthroplasty. J Bone Joint Surg Am 2015;97:1129–1141.
Tousignant M, Moffet H, Nadeau S, Mérette C, Boissy P, Corriveau H, et al. Cost analysis of in-home telerehabilitation for post-knee arthroplasty. J Med Internet Res 2015;17:e83.
Tousignant M, Moffet H, Boissy P, Corriveau H, Cabana F, Marquis F. A randomized controlled trial of home telerehabilitation for post-knee arthroplasty. J Telemed Telecare 2011;17:195–198.
Statistics Canada. Canadian Internet Use Survey. 2012. (last accessed February 28, 2016).
Haight M, Quan-Haase A, Corbett CB. Revisiting the digital divide in canada: The impact of demographic factors on access to the internet, level of online activity, and social networking site usage. Inform Commun Soc 2014;17:503–519.
Pew Research Center's Internet & American Life Project. Home broadband 2013. (last accessed February 28, 2016).

Information & Authors


Published In

cover image Telemedicine and e-Health
Telemedicine and e-Health
Volume 22Issue Number 8August 2016
Pages: 637 - 649
PubMed: 26958932


Published in print: August 2016
Published online: 1 August 2016
Published ahead of print: 9 March 2016
Accepted: 7 December 2015
Received: 21 August 2015


Request permissions for this article.




Patrick Boissy
Université de Sherbrooke and Research Centre on Aging, Sherbrooke, QC, Canada.
Michel Tousignant
Université de Sherbrooke and Research Centre on Aging, Sherbrooke, QC, Canada.
Helene Moffet
Université Laval, Quebec, QC, Canada.
Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec, QC, Canada.
Sylvie Nadeau
Université de Montréal and Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada.
Simon Brière
Université de Sherbrooke and Research Centre on Aging, Sherbrooke, QC, Canada.
Chantal Mérette
Université Laval, Quebec, QC, Canada.
IUSMQ Mental Institute Research Centre, Quebec, QC, Canada.
Hélène Corriveau
Université de Sherbrooke and Research Centre on Aging, Sherbrooke, QC, Canada.
François Marquis
Université Laval, Quebec, QC, Canada.
CHU de Québec-Université Laval, Quebec, QC, Canada.
François Cabana
Université de Sherbrooke and Research Centre on Aging, Sherbrooke, QC, Canada.
CHUS, Sherbrooke, QC, Canada.
Pierre Ranger
Université de Montréal and Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada.
Jean-Talon Hospital, Montreal, QC, Canada.
Étienne L. Belzile
Université Laval, Quebec, QC, Canada.
CHU de Québec-Université Laval, Quebec, QC, Canada.
Ronald Dimentberg
McGill University, Montreal, QC, Canada.
St. Mary's Hospital, Montreal, QC, Canada.


Address correspondence to:Patrick Boissy, PhDResearch Centre on AgingUniversité de Sherbrooke1036 Belvédère SudSherbrooke J1H 4C4Canada
E-mail: [email protected]

Disclosure Statement

No competing financial interests.

Metrics & Citations



Export citation

Select the format you want to export the citations of this publication.

View Options

Get Access

Access content

To read the fulltext, please use one of the options below to sign in or purchase access.

Society Access

If you are a member of a society that has access to this content please log in via your society website and then return to this publication.

Restore your content access

Enter your email address to restore your content access:

Note: This functionality works only for purchases done as a guest. If you already have an account, log in to access the content to which you are entitled.

View options


View PDF/ePub

Full Text

View Full Text







Copy the content Link

Share on social media

Back to Top