In recent years, new scenarios for experimenting telerehabilitation services have been opening thanks to the diffusion of the new technologies. The revolution brought about by the Internet of Things and Big Data Analytics is having an effect also in the field of telerehabilitation services. The literature has broadened in scope and grown in volume and, in certain aspects, the focus of research has changed in the last few years. This article examines the major changes that have come about in the field of telerehabilitation, which can essentially be divided into two main strands: low-cost end-user applications, and the integration of telerehabilitation services. We will briefly review the emerging investigations and experimentations in the field of telerehabilitation, analyzing the market trends in the sector and the commercial strategies of companies working in it, and aim to outline the most relevant challenges that exist for the delivery of effective and sustainable telerehabilitation services. Our opinion is that telerehabilitation currently represents a very promising field, although many questions still remain open, for which concrete and reliable answers are required. In this respect, we focus on a fundamental issue that underlies the field of telerehabilitation services, namely the influence that environment has on the effectiveness of treatment. In short, how can the type of environment affect the results of treatment?
The Telerehabilitation Scenario
Many different terms are used to designate the application of ICTs in the field of healthcare. The term medical informatics, first coined around 1970, was superseded at the end of the 1990s by eHealth, while, nowadays, telemedicine, tele health, and tele care are all used fairly interchangeably.
The main advantages of Telemedicine in healthcare are evident [1-3]. It is a form of secondary prevention encompassing services dedicated to persons classified as at risk or suffering from chronic diseases (e.g. diabetes or cardiovascular disease) who require a constant monitoring of vital parameters in order to reduce the risk of complications, such as that of blood glucose levels for diabetic patients. Meanwhile, Tele-diagnosis focuses on moving diagnostic information rather than the patient. Although a complete diagnosis cannot be performed exclusively through the use of ICT tools, computer-based systems can effectively support diagnostic processes, for example by giving the possibility of exchanging data amongst specialists and facilitating its communication.
Home health monitoring services utilise ITC-based technology to monitor patients in their homes by means of devices that measure vital data, such as blood pressure, glucose levels, pulse, blood oxygen levels, etc., and enable the transmission of this data to clinicians [4,5].
Recently, the concept of telerehabilitation has been introduced to refer to the provision of rehabilitation care at a distance. Telerehabilitation, or e-rehabilitation, is considered a subcomponent of the broader area of telemedicine , and can be divided into three main categories: image based telerehabilitation, sensor based telerehabilitation, and telerehabilitation based on virtual technologies . Lately, the notion of social telerehabilitation has been introduced to distinguish the application of ICT to the social rehabilitation sphere [8,9].
Telerehabilitation is widely considered to be advantageous in the treatment of patients. Telerehabilitation services are seen as being a costeffective alternative to traditional rehabilitation services since they can be delivered at a distance, thus reducing the travel costs and difficulties for patients to receive care at a healthcare facility.
The increasing interest in telerehabilitation is closely related to the diffusion of the internet. Indeed, thanks to the internet, all traditional sectors, including healthcare, are going through processes of transformation in order to become more effective and accurate, as well as cheaper and more powerful.
Telerehabilitation solutions have been experimented in many areas, particularly that of rehabilitation following traumatic injury (for assessment, physical therapy, and monitoring). …