Academic Articles for Telehealth Effectiveness – Physiotherapy

Australian Studies:

• Agreement between telehealth and in-person assessment of patients with chronic musculoskeletal conditions presenting to an advanced-practice physiotherapy screening clinic

This 2018 Australian study compared the results of in-person and telehealth (via video conferencing) assessments on a representative sample of patients with chronic musculoskeletal conditions. Results showed a high level of agreement between the two methods with respect to clinical management decisions and diagnosis.

• Physiotherapy assessment and diagnosis of musculoskeletal disorders of the knee via telerehabilitation

In 2015, the University of Queensland published a study that evaluated the accuracy and reliability of an online musculoskeletal physiotherapy assessment of the knee via video conferencing compared to traditional face-to-face assessment. Results were in exact agreement in 67% of cases and similar in 89% of cases.

• Telerehabilitation is non-inferior to usual care following total hip replacement – A randomized controlled non-inferiority trial

This 2019 Australian trial compared outpatient physiotherapy care via telerehabilitation to in-person physiotherapy after a total hip replacement. The primary outcome assessed was the quality of life subscale of the Hip disability and Osteoarthritis Outcome Score at 6 weeks post-op. Results showed that the telehealth rehabilitation and in-person rehabilitation achieved the same outcome score after 6 weeks. The group that received telerehabilitation scored higher in ease of attending appointments, and patients were more compliant with their home exercise programme.

International Studies:

• Cost analysis of in-home telerehabilitation for post-knee arthroplasty

A 2014 Canadian study compared the costs of in-home telerehabilitation and conventional home visits following knee arthroplasty. At the end of the 8-week trial, the mean cost of a single session was $93.08 CAD for the home visits group and $80.99 for the telehealth group. The cost savings were significant in cases where the patient lived over 30km round trip from the health care centre.

• A physical therapy programme for functional motor symptoms (FMS): A telemedicine pilot study

A 2019 Italian pilot study looked at the effectiveness of a physical therapy telemedicine programme on the motor symptoms of patients with FMS. Self- assessment by patients showed 77.8% reported improvement after 24 weeks of the programme. A significant improvement was Psychogenic movement disorders rating scale was also seen.

• Home-based telemedicine in patients with chronic neck pain

A 2015 study in the USA aimed to investigate if a home-based telemedicine program, directed by a clinician and managed by a nurse, could reduce chronic neck pain for sufferers. The program ran for 6 months and results of patients were compared to patients with no home-based therapy program and only the recommendation to continue exercises at home. Results showed a significantly higher decline in pain and disability with the home-based telemedicine group.

 Can Telemedicine Replace the First Post Op Visit for Knee Arthroscopy in Adolescents?

A 2018 American study looked the feasibility a video/audio visit compared to routine face-to-face post-operative visits for adolescents that had undergone knee surgery. The main objectives were to determine telehealth’s effectiveness in demonstrating range of motion, and knee effusion and incision colour. Results showed practitioners had 100% agreement with incision colour and effusion size in both assessment settings. Knee flexion range of motion was slightly different between in person and video, but this was not clinically significant. Extension range of motion was similar between the groups.

• The comparison of telerehabilitation and face-to-face rehabilitation after total knee arthroplasty: A systematic review and meta-analysis

This 2016 Chinese published meta-analysis compared telerehabilitation to face to facerehabilitation after a total knee replacement. Medline, SCOPUS, Google Scholar, EMBASE, Springer, Science Direct, and Cochrane databases were searched electronically. Results suggested that telemedicine could achieve comparable pain relief and achieved significantly higher extension range and quadricep strength.

Academic evidence