In-Home Telerehabilitation for Post-Knee Arthroplasty: A Pilot Study


  • Michel Tousignant Research Centre on Aging, Sherbrooke Geriatric University Institute
  • Patrick Boissy Department of Kinesiology, University of Sherbrooke
  • Hélène Corriveau Research Centre on Aging, Sherbrooke Geriatric University Institute
  • Hélène Moffet Department of Rehabilitation, Faculty of Medicine, Laval University
  • François Cabana Faculty of medicine, University of Sherbrooke



The purpose of this study was to investigate the efficacy of in-home telerehabilitation as an alternative to conventional rehabilitation services following knee arthroplasty. Five community-living elders who had knee arthroplasty were recruited prior to discharge from an acute care hospital. A pre/post-test design without a control group was used for this pilot study. Telerehabilitation sessions (16) were conducted by two trained physiotherapists from a service center to the patient’s home using H264 videoconference CODECs (Tandberg 550 MXP) connected at 512 Kb\s. Disability (range of motion, balance and lower body strength) and function (locomotor performance in walking and functional autonomy) were measured in face-to-face evaluations prior to and at the end of the treatments by a neutral evaluator. The satisfaction of the health care professional and patient was measured by questionnaire. Results are as follows. One participant was lost during follow-up. Clinical outcomes improved for all subjects and improvements were sustained two months post-discharge from in-home telerehabilitation. The satisfaction of the participants with in-home telerehabilitation services was very high. The satisfaction of the health care professionals with the technology and the communication experience during the therapy sessions was similar or slightly lower. In conclusion, telerehabilitation for post-knee arthroplasty is a realistic alternative for dispensing rehabilitation services for patients discharged from an acute care hospital.

Keywords: Telerehabilitation, Physical Therapy, Total Knee Arthroplasty, Videoconferencing



Aarnio, P., Lamminen, H., Lepisto, J., & Alho, A. (1999). A prospective study of teleconferencing for orthopaedic consultations. Journal of Telemedicine and Telecare, 5(1), 62-66.

Berg, K., Wood-Dauphinee, S., & Williams, J. I. (1995). The Balance Scale: Reliability assessment with elderly residents and patients with an acute stroke. Scand J Rehabil Med, 27(1), 27-36.

Berg, K. O., Wood-Dauphinee, S., Williams, J. L., & Gayton, D. (1989). Measuring balance in the elderly: Preliminary development of an instrument. Physiotherapy Canada, 41, 304-311.

Berg, K. O., Wood-Dauphinee, S. L., Williams, J. I., & Maki, B. (1992). Measuring balance in the elderly: Validation of an instrument. Canadian Journal of Public Health, 83 Suppl 2, S7-11.

Bohannon, R. W., & Cooper, J. (1993). Total knee arthroplasty: Evaluation of an acute care rehabilitation program. American Academy of Physical Medicine and Rehabilitation, 74(10), 1091-1094.

Cooper, R. A., Fitzgerald, S. G., Boninger, M. L., Brienza, D. M., Shapcott, N., Cooper, R., et al. (2001). Telerehabilitation: Expanding access to rehabilitation expertise. Proceedings of the IEEE, 89(8), 1174-1193.

Dowsey MM, Kilgour ML, Santamaria NM, & Choong, PF. (1999). Clinical pathways in hip and knee arthroplasty: A prospective randomised controlled study. Medial Journal Australian, 170(2), 59-62.

Forducey, P. G., Ruwe, W. D., Dawson, S. J., Scheideman-Miller, C., McDonald, N. B., & Hantla, M. R. (2003). Using telerehabilitation to promote TBI recovery and transfer of knowledge. NeuroRehabilitation, 18(2), 103-111.

Hamel, M., Fontaine, R., & Boissy, P. (2008). In-home telerehabilitation for geriatric patients. IEEE Engineering in Medicine and Biology Magazine, 27(4), 29-37.

Hebert, R., Carrier, R., & Bilodeau, A. (1988). The Functional Autonomy Measurement System (SMAF): Description and validation of an instrument for the measurement of handicaps. Age Ageing, 17(5), 293-302.

Information, C. I. f. H. (2003). Number of total hip and knee replacement procedures and percent change in Canada 1995-2001:

Jones, C. J., Rikli, R. E., & Beam, W. C. (1999). A 30-s chair-stand test as a measure of lower body strength in community-residing older adults. Research Quarterly for Exercise and Sport, 70(2), 113-119.

Lemaire, E., Necsulescu, L., & Greene, G. (2006). Service delivery trends for a physical rehabilitation outreach program. Disability and Rehabilitation, 28(21), 1349-1359.

Lemaire, E. D., Boudrias, Y., & Greene, G. (2001). Low-bandwidth, Internet-based videoconferencing for physical rehabilitation consultations. Journal of Telemedicine and Telecare, 7(2), 82-89.

LeRouge, C., Garfield, M. J., & Hevner, A. R. (2002). Quality attributes in telemedicine video conferencing. Paper presented at the 35th Annual Hawaii International Conference on Systems Sciences, Hawaii.

Ministère de la Santé et des Services sociaux du Québec. (2004). Chez soi : Le premier choix. Précisions pour favoriser l’implantation de la politique de soutien à domicile. Québec: La Direction des communications, MSSS-Québec.

NIH Consensus Development Program. (2003). NIH Consensus Development Conference on Total Knee Replacement. Final Statement.

Ohinmaa, A., Vuolio, S., Haukipuro, K., & Winblad, I. (2002). A cost-minimization analysis of orthopaedic consultations using videoconferencing in comparison with conventional consulting. Journal of Telemedicine and Telecare, 8(5), 283-289.

Podsiadlo, D., & Richardson, S. (1991). The timed “Up & Go”: A test of basic functional mobility for frail elderly persons. Journal of the American Geriatrics Society, 39(2), 142-148.

Tousignant, M., Boissy, P., Corriveau, H., & Moffet, H. (2006). In home telerehabilitation for older adults after discharge from an acute hospital or rehabilitation unit: A proof-of-concept study and costs estimation. Disability and Rehabilitation Assistive Technology, 1(4), 209-216.

Wakeford, L., Wittman, P. P., White, M. W., & Schmeler, M. R. (2005). Telerehabilitation position paper. Am J Occup Ther, 59(6), 656-660.

Winters, J. M. (2007). Videoconferencing and telehealth technologies can provide a reliable approach to remote assessment and teaching without compromising quality. J Cardiovasc Nurs, 22(1), 51-57.



How to Cite

Tousignant, M., Boissy, P., Corriveau, H., Moffet, H., & Cabana, F. (2009). In-Home Telerehabilitation for Post-Knee Arthroplasty: A Pilot Study. International Journal of Telerehabilitation, 1(1), 9–16.




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