The sudden onset of pandemic restrictions in early 2020 had dramatic effects on the delivery of health care and the progress of research. Limitations on in-person visits provided the impetus for a renewed perspective on options for remote engagement. Stakeholders in health care and research for spinal cord injury are assessing which options are best suited for timely interactions that are safe, secure, accessible, effective, and efficient for individuals with spinal cord injury and professionals in the field. As the pandemic continues to evolve, so will options for delivering care and conducting research.
Given the importance of access to care and research studies to outcomes of spinal cord injury, it is important to build upon the gains in remote options and encourage their wider role in in spinal cord injury care. Remote interactions minimize the need to travel to appointments and the risks of in-person visits - especially important for people with disabilities - but raise issues of accessibility, privacy, and reimbursement. For these options to be maintained, there are pressing needs to address internet access, technology requirements, training, privacy concerns, and insurance coverage for telemedicine and telehealth visits, issues that are more likely to affect the chronically underserved.
Various systems of care show evidence that rehabilitation and follow up care for spinal cord injury can be effectively delivered remotely.Citation1–3 Some types of appointments are readily adaptable to telehealth visits, such as nutritional and psychological counseling.Citation4,Citation5 Incorporating digital technologies into care protocols will further the ability to monitor other services, including rehabilitation, that are delivered remotely.Citation6.
The pandemic influenced the course of ongoing rehabilitation research studies and sent upcoming studies in new directions. To maintain the momentum of rehabilitation research, the stakeholders came up with creative solutions, adapting in-person studies to tele studies where possible, and finding ways to minimize in-person contact. The sudden shift to telemedicine portended a shift to telerehabilitation, accelerating movement toward designing studies for virtual platforms and remote data collection. Virtual reality, gaming platforms, and wearable technologies are among the tools with the potential for expanding the options for delivery of rehabilitative care.Citation5,Citation7–12.
The lessons learned from the pandemic experience are fundamentally altering perspectives on delivering care and conducting research in injuries and dysfunction of the spinal cord. Transforming certain aspects of care and research for remote engagement may help close gaps in care and enhance diversity in research studies. Achieving better outcomes depends on ensuring equitable access to the tools and services for internet access and providing needed support, to avoid leaving vulnerable populations behind.
Conflict of interest
No potential conflict of interest was reported by the author(s).
References
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