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A Telerehabilitation Intervention for Persons with Spinal Cord Dysfunction

Houlihan, Bethlyn Vergo MSW, MPH; Jette, Alan PhD, PT; Paasche-Orlow, Michael MD, MA, MPH; Wierbicky, Jane RN; Ducharme, Stan PhD; Zazula, Judi MS, OTR/L; Cuevas, Penelope MD; Friedman, Robert H. MD; Williams, Steve MD

American Journal of Physical Medicine & Rehabilitation: September 2011 - Volume 90 - Issue 9 - p 756-764
doi: 10.1097/PHM.0b013e31820b140f
Brief Report: SCI

Pressure ulcers and depression are common preventable conditions secondary to a spinal cord dysfunction. However, few successful, low-cost preventive approaches have been identified. We have developed a dynamic automated telephone calling system, termed Care Call, to empower and motivate people with spinal cord dysfunction to improve their skin care, seek treatment for depression, and appropriately use the healthcare system. Herein, we describe the design and development of Care Call, its novel features, and promising preliminary results of our pilot testing. Voice quality testing showed that Care Call was able to understand all voice characteristics except very soft-spoken speech. Importantly, pilot study subjects felt Care Call could be particularly useful for people who are depressed, those with acute injury, and those without access to quality care. The results of a randomized controlled trial currently underway to evaluate Care Call will be available in 2011.

From the Department of Health Policy & Management (BVH) and the Health & Disability Research Institute (AJ), Boston University School of Public Health; Section of General Internal Medicine, Department of Medicine (MP-O, PC, RHF), and the Department of Physical Medicine and Rehabilitation (SD, SW), Boston University School of Medicine; and the New England Regional Spinal Cord Injury Center (BVH, JW, JZ, SW) and Rehabilitation Medicine (SD), Boston Medical Center, Massachusetts.

All correspondence and requests for reprints should be addressed to: Bethlyn Vergo Houlihan, MSW, MPH, New England Regional SCI Center, Boston Medical Center, 732 Harrison Ave, F511, Boston, MA 02118.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article. Supported by Centers for Disease Control and Prevention grant 5R01DD000155, Department of Health and Human Services. Presented in poster format (portions of content) at the Spinal Cord Injury Contemporary Forums Conference, Orlando, FL, 2009; the American Congress of Rehabilitation Medicine Annual Conference, Denver, CO, 2009; and the International Spinal Cord Society Annual Meeting, Florence, Italy, 2009.

© 2011 Lippincott Williams & Wilkins, Inc.