Overcoming language barriers to provide telerehabilitation for COVID-19 patients: a two-case report

Figures & data

Figure 1. Case 1: The therapist’s side during a telerehabilitation session. The physical therapist provided instructions and feedback to the patient using Google Translate. The assistant corrected the dictated text and provided the translated instructions and feedback to the patient using the read-out function on the patient's tablet.

Figure 2. Case 2: Telerehabilitation session using cue cards. The therapist gave instructions to the patient by presenting him with cue cards during the video call.

Table 1. List of cue cards’ contents.

Categories	Contents
Introduction	Hello, my name is (therapist’s name), and I will be your instructor for today’s telerehabilitation program.
	How are you feeling today?
Application setup	First of all, let us set up the application.
	Please listen to my explanation in its entirety.
	First, tap the “Home” button at the bottom of the screen.
	When you see a screen with a row of icons, tap the TeamViewer app.
	Wait for a moment, and you will see a message box that says: “Requesting connection”.
	Then, tap the “Allow” button at the bottom right of the message box.
	Once this is done, I can remotely control your tablet.
	That is all I have to say, do you need me to explain again?
	Please begin the operation.
	Very well, I am now successfully connected. Thank you for your cooperation.
Vital-signs check	The next step is to check your physical condition before the exercises.
	Do you have the pulse oximeter that we gave you with the tablet?
	Can you put it on?
	Now measuring.
	Your heart rate and blood oxygen levels are acceptable.
	Do you have any other physical ailments?
	If you experience shortness of breath or feel sick during the exercises, please let me know right away.
Exercise	Then, let us start the exercise.
	The exercise video program is about 10 min long.
	Move your body along with the video.
	Very good. Keep it up.
	Please perform the exercises in a seated position.
	Let us try to move some more.
	That would be all for the exercise phase. Now, I will check your physical condition following the exercises.
Scheduling and closure	Thank you for your time. Next time, the session will be… (date and time).
	Please do not forget to charge your tablet and pulse oximeter.
	See you next time.
Troubleshooting	Something is wrong and you are not showing up here. I will try to re-establish the connection.
	I apologise for not being able to connect easily.

A list of the contents on the cue cards. In practice, the cue cards were handwritten in Japanese on A4 paper (29.7 × 24 cm).

Table 2. Results of the Telemedicine Satisfaction Questionnaire and additional questions in Case 2.

Telemedicine Satisfaction Questionnaire
Questions	Score
Factor 1: Quality of care provided
I do not need assistance while using the system	5
I think the health care provided via telemedicine is consistent	4
I obtain better access to health care services by using telemedicine	4
I receive adequate attention	4
Telemedicine suits my health care needs	4
I find telemedicine an acceptable way to receive health care services	4
I will use telemedicine services again	4
Overall, I am satisfied with the quality of service being provided via telemedicine	4
Factor 2: Similarity to face-to-face encounter
I can talk with my health care provider easily	5
I can hear my health care provider clearly	–
My health care provider is able to understand my health care condition	4
I can see my health care provider as if we met in person	4
Telemedicine saves me time travelling to the hospital or a specialist clinic	5
Factor 3: Perception of the interaction
I feel comfortable communicating with my health care provider	4
Additional questions
Questions	Score
I can easily understand how to move during the exercises	4
I feel safe performing the exercise	4
The room environment is appropriate for performing the exercise programme	4
The devices used are appropriate for performing the exercise programme	4
Telecommunication with medical experts during the exercises is helpful	4

The results of the Telemedicine Satisfaction Questionnaire and additional questions after the first telerehabilitation session in Case 2 are shown.

Scores: 5 = strongly agree, 4 = agree, 3 = undecided, 2 = disagree, 1 = strongly disagree.