Let’s Go to the Video – The Research on TelePT

Telehealth research

Let’s Go to the Video – The Research on TelePT

For a few years I’ve believed that telehealth would soon become an integral part of Physical Therapy. We all shop online. Even before COVID, more people were working from home. Technology is improving every day. It seemed obvious to me that healthcare was the next service to follow suit. I never expected it to occur with such a monumental watershed moment, but now it’s here. The pandemic of 2020 will also have lasting effects on patient utilization of outpatient PT as we know it. TelePT will be a part of most future PT practice models, and those that don’t adapt won’t survive.

During the telehealth boom of 2020, there’s been a consistent issue for Physical Therapists and their patients. There’s a myth that Telehealth PT is not as valuable or effective as in-person assessments or treatments. I’ve been researching this for a while. I’ve had a few studies that I often cite, but recently I dug a little deeper. There’s plenty of research and I’d like to share some of it here.

TelePT may not be for every patient, but it is extremely valuable to many, for now and the future. You may not be sure TelePT is right for you. If you’re reading this, you have the technology to take advantage of the convenience, safety and effectiveness of TelePT. This new way of doing PT can be effective in many ways that would otherwise be impossible. The studies I’ve cited below show that. We’re still early in the game, but this is a great start and an excellent launching point for additional research that’s being done now. With that, I present a selection of studies on Telehealth Physical Therapy (TelePT).

Orthopedic Studies

Real-time Telerehabilitation for the Treatment of Musculoskeletal Conditions Is Effective and Comparable to Standard Practice: A Systematic Review and Meta-Analysis (2017 Meta-analysis)
Results – Telerehabilitation is effective in the improvement of physical function, while being slightly more favorable than the control cohort following intervention. Treatment delivered solely via telerehabilitation is equivalent to face-to-face intervention for the improvement of physical function. The improvement of pain was also seen to be comparable between cohorts following intervention.
Conclusions – Real-time telerehabilitation appears to be effective and comparable to conventional methods of healthcare delivery for the improvement of physical function and pain in a variety of musculoskeletal conditions.

 

The Validity of Physical Therapy Assessment of Low Back Pain via Telerehabilitation in a Clinical Setting (2014 Randomized Control Trial)
Results – High levels of agreement were found with detecting pain with specific lumbar movements, eliciting symptoms, and sensitizing the SLR test. Moderate agreement occurred with identifying the worst lumbar spine movement direction, SLR range of motion, and active lumbar spine range of motion. Poor agreement occurred with postural analysis and identifying reasons for limitations to lumbar movements.
Conclusions – This study validates elements of the physical assessment of the lumbar spine and identifies technical and clinical issues to be addressed by future research. Important components of the standard musculoskeletal assessment of LBP are valid via telerehabilitation in a clinical setting.

 

Telerehabilitation Mediated Physiotherapy Assessment of Ankle Disorders (2010)
Results – An 80% exact agreement in primary systems diagnosis was found between face-to-face and telerehabilitation assessments. Clinical observations were found to have very strong agreement for categorical data and significant agreement for binary data.
Conclusions – This study demonstrates the validity and reliability of musculoskeletal assessments of the ankle using telerehabilitation.

Surgical Studies

Effectiveness of Physiotherapy With Telerehabilitation in Surgical Patients: A Systematic Review and Meta-Analysis (2018 Meta-Analysis)
Conclusions – TelePT has the potential to increase quality of life, is feasible, and is at least equally effective as usual care in surgical populations.

 

Evidence of Benefit of Telerehabitation After Orthopedic Surgery: A Systematic Review – “We found strong evidence in favor of telerehabilitation in patients following total knee and hip arthroplasty” (2017 Review)

Discussion – This is the first attempt at evaluating the quality of telerehabilitation intervention research after surgery on orthopedic conditions in a systematic review.
Conclusions – We found strong evidence in favor of telerehabilitation in patients following total knee and hip replacement and limited evidence in the upper limb interventions (moderate and weak evidence).

 

HSS@Home, Physical Therapist-Led Telehealth Care Navigation for Arthroplasty Patients: A Retrospective Case Series (2019 Pilot)
Results – There were no readmissions among the 19 surgery patients. Nurse practitioners were consulted for all patients, predominantly for non-emergent reasons. Feedback from patients and physicians was positive, and no overutilization of care was found.
Conclusions – HSS@Home was a promising alternative to live, in-home physical therapy that was effective in monitoring this series of patients after hip or knee replacement. This study sets the stage for further research into telehealth rehabilitative care for patients who undergo joint replacement surgery.

 

 

Neurological Studies

Telerehabilitation for Stroke Survivors: Systematic Review and Meta-Analysis (2018 Meta-analysis)
Results – Included 15 studies (1339 patients) in the systematic review. No significant differences between the telerehabilitation and control groups in terms of the Barthel Index, Berg Balance Scale, Fugl-Meyer Upper Extremity, and Stroke Impact Scale scores. The majority of included studies showed that both groups were comparable for quality of life, CSI, and patients’ satisfaction. One study showed that the cost of telerehabilitation was lower than usual care by $867.
Conclusions – Telerehabilitation can be a suitable alternative to usual rehabilitation care in stroke patients, especially in remote or underserved areas.

 

This research shows promising evidence that telerehab and TelePT can be an extremely effective way of providing care. Additional studies have been completed during the recent public health emergency. Check back to this blog for updates on the latest research.

To begin taking advantage of the benefits of TelePT, Schedule an Appointment with Better TelePT today.

Daniel Seidler, PT, MS
dan@bettertelept.com

Daniel has had the pleasure of being a Physical Therapist since graduating from Columbia University in 1996. He's the former owner of WSPT in the Bronx, NY. Since 2018, Telehealth PT has been his passion and his mission. Throughout his career, Daniel has thrived as a healthcare innovator, entrepreneur, and executive. Daniel provides educational programming to PT students, Physical Therapists and Physician Assistants on the basics and nuances of TelePT. He also continues to treat patients via Telehealth. Daniel is a member of the American Physical Therapy Association, the American Telemedicine Association, he is an Advisory Board Member of the Mercy College Physical Therapy program and a member of the Pace University Lubin Design Thinking Certificate Program. He also loves spending time with his family, running in Prospect Park and doing the NY Times Sunday Crossword.