Telerehab…a viable option?

This pre-COVID systematic review based on 13 studies evaluated the effectiveness of in clinic rehab versus telerehab for the management of a variety of musculoskeletal conditions.¹

Result #1: Telerehab is equivalent to face-to-face intervention for the improvement of function and pain

Result #2: Telerehab in addition to usual care is more favourable than usual care alone

Another pre-COVID study looked at the level of agreement between of physiotherapists providing telehealth via videoconferencing versus in-person assessment.²

Patients with chronic musculoskeletal conditions such as low back, knee or shoulder pain underwent two consecutive assessments by different physiotherapists within a single clinic session.

Result #1: There was substantial agreement between in-person and telehealth assessments for recommended managements

Result #2: There was near perfect agreement for referral to other allied health professionals

Result #3: There was substantial agreement when requesting further investigations

Result #4: Overall, participants were also satisfied with the telehealth assessment

Conclusion: “Telehealth can be considered as a viable and effective medium to assess those patients who are unable to attend these services in person.” (Cottrell et al 2017)

This 2018 Australian survey study wanted to see if telehealth is an acceptable mode of physiotherapy delivery, from the perspective of patients with chronic musculoskeletal conditions.³

Result #1: Over half were willing to use telehealth if it reduced the costs and time associated with attending real appointments

Result #2: Patients who worked full-time were more likely to use telehealth if it reduced work absenteeism

Result #3: More than 3/4 of patients had computer and wifi access to allow for home telehealth

Result #4: Almost half of the patients surveyed would prefer home telehealth over having to travel to attend their appointments

This 2018 study evaluated the clinicians’ perspectives on providing telerehab.⁴

Result #1: Confidence in providing treatment via telerehab significantly improved with time

Result #2: Clinicians became significantly more accepting of telerehab being a time- and cost-effective

Result #3: Overall PT satisfaction was high, and with time, the use of the new technology became easier

Result #4: The ability to establish rapport significantly improved with experience

Although cautious, physiotherapists are overall accepting of telerehab, acknowledging that it is a viable option for those unable to attend a clinical setting for various reasons.⁵ Perhaps a hybrid model will come out of post-COVID times.

References:

1. Cottrell MA et al Agreement between telehealth and in-person assessment of patients with chronic musculoskeletal conditions presenting to an advanced-practice physiotherapy screening clinic. Musculoskelet Sci Pract. 2018 Dec;38:99-105.

2. Cottrell MA et al Real-time telerehabilitation for the treatment of musculoskeletal conditions is effective and comparable to standard practice: a systematic review and meta-analysis. Clin Rehabil. 2017 May;31(5):625-638.

3. Cottrell MA et al Patients are willing to use telehealth for the multidisciplinary management of chronic musculoskeletal conditions: A cross-sectional survey. J Telemed Telecare. 2018 Aug;24(7):445-452.

4. Cottrell MA et al Clinicians’ Perspectives of a Novel Home-Based Multidisciplinary Telehealth Service for Patients with Chronic Spinal Pain. Int J Telerehabil. 2018 Dec 11;10(2):81-88.

5. Cottrell MA et al Service provider perceptions of telerehabilitation as an additional service delivery option within an Australian neurosurgical and orthopaedic physiotherapy screening clinic: A qualitative study. Musculoskelet Sci Pract. 2017 Dec;32:7-16.