Follow-up consultations through telerehabilitation for wheelchair recipients with paraplegia in a developing country: a case report

Abstract

Persons with disability (PWD) in the Philippines find it difficult to attend regular face-to-face rehabilitation due to distance, transportation and food expenses, disability, and time constraints. Being a developing country, Filipino rehabilitation doctors have to be resourceful to overcome these barriers and try alternative ways to reach out to their patients, such as through telemedicine, specifically telerehabilitation. After receiving free wheelchairs, two patients with paraplegia secondary to spinal cord disease were unable to report for in-clinic wheelchair reassessment. Telerehabilitation was attempted for the first time to conduct wheelchair follow-up using a commonly available social media application through synchronous and asynchronous methods. During the teleconsultation, the rehabilitation doctors used the wheelchair follow-up form from the World Health Organization translated into Filipino. There were apprehensions at first, especially from the side of the patients, regarding the method, effectiveness, and safety of telerehabilitation. In the end, the patients found telerehabilitation easy, safe, and convenient, and were satisfied with the practical wheelchair modifications and exercise recommendations. Telerehabilitation is a viable alternative to provide universal access to rehabilitation care and overcome the barriers to in-clinic visits among indigent PWD in a resource-limited country. Unlike in developed countries, we do not have readily available customized telemedicine platforms and telemonitoring equipment to conduct telerehabilitation. Nonetheless, we can make use of what is locally available, affordable, and convenient to our patients.