Telehealth Clinical Practice Guide for Occupational Therapy, Physical Therapy, and Speech and Language Pathology: A Saudi and Middle Eastern Guide.

Telehealth refers to the application of telecommunications technology to deliver clinical services at a distance by linking clinician to patient, caregiver, or any person(s) involved in client care for assessment, intervention, consultation, and supervision. Telehealth for occupational therapy (OT), physical therapy (PT), and speech and language pathology (SLP) have produced service delivery venues that are of great benefit during the coronavirus disease 2019 pandemic. The concept of telehealth for rehabilitation services is relatively new in the Middle East, and no specialty-specific clinical practice standards or guidelines are published to guide the rehabilitation practitioners. Therefore, a specialty-specific telehealth practice guide for rehabilitation practitioners has been developed by an expert panel in the field of rehabilitation. This guide is documented in this article. Such a guide will be beneficial when providing tele-evaluation, teleintervention/telerehabilitation, teleconsultation, and telemonitoring through communication technologies. The purpose of this guide is to enable understanding of core telehealth clinical principles and aid the provision of OT, PT, and SLP telehealth services in Saudi Arabia. Also, the guide can potentially be implemented in other Middle Eastern countries. The guide is based on key telehealth guidelines involving the American Occupational Therapy Association telehealth resources, American Physical Therapy Association, American Speech and Hearing Association, telemedicine policies in Saudi Arabia by the national health information center at the Saudi Health Council, and a blueprint for telerehabilitation guidelines that are based on the American Telemedicine Association's Core Standards for Telemedicine Operations.

Telerehabilitation Guidelines in Saudi Arabia.

Rehabilitation needs are increasing globally due to population growth, aging population, high survival rates for people with disability, and severe health conditions. In the past few years, new telecommunication-based practices, including various forms of e-rehabilitation have gained attention all over the world, including the Kingdom of Saudi Arabia (KSA). Telerehabilitation is an alternative way of delivering rehabilitation services in which information and communication technologies are used to expedite communication between the health care professional and the patient at a distant location. It can be beneficial to people in rural areas, especially individuals in isolated communities. At present, the COVID-19 pandemic has forced speedy adoption of telerehabilitation due to restricted traditional in-person visits all over the world, including KSA; however, no telerehabilitation guidelines are available in the country. Since specialized rehabilitation services are limited to main cities of the country, the provision of care by reaching out the underserved areas using telemedicine technology is deemed important. These guidelines were established collaboratively by panel of various rehabilitation experts with input from other practitioners in the field and strategic stakeholders. It will facilitate rehabilitation clinicians practicing in KSA providing consultation, counseling, education, assessment, monitoring, therapy, or follow-up to a patient remotely using telemedicine communication technologies. This document includes administrative, clinical, and technical guidelines, which are aimed to standardize telerehabilitation practice across the country. The core principles are based on standards set forth by American Telemedicine Association and are guided by telemedicine policy in KSA. Additionally, ethical considerations of telerehabilitation practice pertinent to Saudi culture and health care system are elaborated as well. This document serves as a general guide for the provision of telerehabilitation services and do not describe a specialty-specific clinical practice guideline.

Translation, cultural adaptation, and validation of Cognistat for its use in Arabic-speaking population with acquired brain injury.

BACKGROUND: The use of cognitive assessment tools is central to the detection of cognitive impairment in acquired brain injury patients. Cognistat is a commonly used cognitive screening tool that can detect cognitive deficits among patients with neurological and psychiatric conditions. Cognistat examines different major ability areas including level of language, construction, memory, calculation, reasoning, consciousness, orientation and attention. To date, Cognistat has not been translated/adapted for use in Arabic-speaking countries. AIM: The aim of this paper is to provide normative data for the use of Cognistat in Arabic-speaking populations with acquired brain injury. DESIGN: Cross-cultural validation study. SETTING: Inpatient TBI and stroke rehabilitation ward in a rehabilitation hospital. POPULATION: A total of 107 healthy Arabic-speaking adults and 62 acquired brain injury patients were involved in the study. METHODS: After the completion of the cross-cultural adaptation process, psychometric properties of the adapted cognitive tool were evaluated. RESULTS: The Arabic version of Cognistat was found to have acceptable internal consistency, and the test-retest reliability showed high stability of scores over time. For concurrent validity, patients' performance on the Arabic version of Cognistat and the Mini-Mental State Examination were compared with excellent correlations overall. Significant differences between the performance of patients and the control group were found on all sub-tests. CONCLUSIONS: The Arabic version of Cognistat appears to be a valid and reliable cognitive screening tool. It is anticipated that the Arabic version of Cognistat will be widely used in the Arabic-speaking countries, allowing for a very precise evaluation of cognitive deficits in acquired brain injury patients. CLINICAL REHABILITATION IMPACT: As part of the rehabilitation process, health care professionals are regularly required to test patients' cognitive abilities using appropriate measures. The findings of the study provide key solutions for the clinical assessment of Arabic populations: such cognitive tools could help improve the cognitive rehabilitation practice for the Arabic population by offering validated, reliable, and culturally adapted tests in the Arabic language.