Virtual Physio Research
A 2021 umbrella mapping review with meta-meta-analysis aimed to determine if virtual physiotherapy could be an effective alternative to conventional rehab in physiotherapy practice. This study identified 29 articles comparing virtual physiotherapy to standard practice in musculoskeletal, cardiovascular, and neurological treatment settings. The results demonstrated that there was no statistically significant difference between virtual physiotherapy and usual care for improvements in physical function. Notably, the authors identified 6 reviews in favour of virtual physiotherapy for patients with neurological conditions (statistically significant but negligible effect size). The authors concluded that virtual physiotherapy provides positive clinical results that are comparable to usual care.
2. A 2018 systematic review and meta-analysis aimed to study the effectiveness of virtual physiotherapy on functional outcomes and quality of life in surgical patients compared to usual care. Of the 23 studies included for qualitative synthesis, 7 were eligible for quantitative synthesis on quality of life. Results demonstrated an increase in quality life measures in favour of virtual physiotherapy. The authors concluded that virtual physiotherapy has the potential to increase quality of life and is equally effective as usual care in this surgical population.
3. A 2016 Systematic review and meta-analysis aimed to evaluate the effectiveness of virtual physiotherapy for the management of musculoskeletal conditions as well as if virtual physiotherapy is comparable to conventional in-person treatment. A literature search was performed of six databases for research studying the outcomes of real-time telerehabilitation for musculoskeletal conditions. 13 studies with a total of 1520 participants met the inclusion criteria. The authors concluded that virtual physiotherapy is effective and comparable to traditional in-person physiotherapy for improving physical function and decreasing pain for a variety of musculoskeletal conditions.
4. A 2018 systematic review and meta-analysis compared telerehab to standard in person physiotherapy for patients after a total knee replacement. Pooled results showed patient-reported function, post-operative range of motion into extension, and quadriceps muscle strength were found to be significantly better in the telerehab group compared to the standard in person rehab. With respect to pain reduction and range of motion into flexion, no differences were observed between groups.
5. A 2020 randomized control trial compared the effects of video exercise instruction versus in person exercise instruction for patients (n=56) with chronic nonspecific low back pain over a 12 week period. The studied outcomes were intensity of low back pain as well as disability measured using the Oswestry Disability Questionnaire. The 1 and 3 month follow-up indicated that there were no significant differences between video and in person exercise instruction for either pain nor disability outcomes. The authors noted that video exercise had a few benefits including the following: ease of performance; minimal side effects; patient satisfaction; some participants preferred video instruction.
6. A 2018 randomized control trial compared 18 patients after an arthroscopic subacromial decompression surgery (shoulder surgery for rotator cuff pain). Patients either completed 12 weeks of telerehab or 12 weeks of standard physiotherapy. The groups were compared at 4, 8, and 12 weeks after surgery. Results showed no statistical significant difference between groups on measures of pain, range of motion, function, and strength.
7. A 2013 qualitative embedded single case study conducted semi-structured interviews for 5 patients following a total knee replacement and 8 weeks of telerehab. Following qualitative thematic analysis, 6 themes were presented from the patients’ perspective: (1) improving access to services with reduced need for transportation; (2) developing a strong therapeutic relationship with therapist while maintaining a sense of personal space; (3) complementing telerehabilitation with in-person visits; (4) providing standardized yet tailored and challenging exercise programs using telerehabilitation; (5) perceived ease-of-use of telerehabilitation equipment; and (6) feeling an ongoing sense of support.
8. A 2016 study using a repeated-measures design looked at 18 patients with knee pain. All patients participated in both a traditional in-person physiotherapy assessment and a virtual physiotherapy assessment. The virtual assessment involved patients performing self-palpation and modified orthopaedic tests as well as active and functional movement tests. The study demonstrated that the diagnosis was found to be in agreement in 94% of the cases and that virtual physiotherapy assessment of the knee is both feasible and reliable.
9. A 2019 study investigated the concurrent validity and reliability of virtual physiotherapy compared to in-person physiotherapy assessment with respect to neck pain. Results showed that virtual physiotherapy assessment of the neck is both statistically reliable and valid for measuring pain intensity, active range of motion, neck muscle strength/endurance, neck posture, as well as disability.
10. A 2012 study involving 10 patients with elbow pain compared the patho-anatomical diagnosis, systems diagnosis, and physical exam findings of in-person physiotherapy assessment to virtual physiotherapy assessment. The authors concluded that performing a virtual physiotherapy assessment of the elbow joint complex is both valid and reliable.
11. This 2023 systematic review involved ten repeated-measures studies and 193 participants aged 23-62 years. The study reported “Evidence ranging from very low to high certainty suggests that validity and reliability of digital physiotherapy assessments are acceptable to excellent for several assessment components. Digital physiotherapy assessment may be a viable alternative to face-to-face assessment for patients who are likely to benefit from the accessibility and convenience of remote access.”
References
Luis Suso-Martí, PT, MSc, Roy La Touche, PT, PhD, Aida Herranz-Gómez, PT, MSc, Santiago Angulo-Díaz-Parreño, MSc, Alba Paris-Alemany, MD, PhD, Ferran Cuenca-Martínez, PT, MSc, Effectiveness of Telerehabilitation in Physical Therapist Practice: An Umbrella and Mapping Review With Meta–Meta-Analysis, Physical Therapy, Volume 101, Issue 5, May 2021, pzab075
van Egmond MA, van der Schaaf M, Vredeveld T, Vollenbroek-Hutten MMR, van Berge Henegouwen MI, Klinkenbijl JHG, Engelbert RHH. Effectiveness of physiotherapy with telerehabilitation in surgical patients: a systematic review and meta-analysis. Physiotherapy. 2018 Sep;104(3):277-298. doi: 10.1016/j.physio.2018.04.004. Epub 2018 Jun 19. PMID: 30030037.
Cottrell MA, Galea OA, O'Leary SP, Hill AJ, Russell TG. 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. doi: 10.1177/0269215516645148. Epub 2016 May 2. PMID: 27141087.
Jiang, S., Xiang, J., Gao, X., Guo, K., & Liu, B. (2018, May). The comparison of telerehabilitation and face-to-face rehabilitation after total knee arthroplasty: A systematic review and meta-analysis. J Telemed Telecare, 24(4), 257-262.
Dadarkhah A, Rezaimoghadam F, Najafi S, Mohebi B, Azarakhsh A, Rezasoltani Z. Remote Versus in-Person Exercise Instruction for Chronic Nonspecific Low Back Pain Lasting 12 Weeks or Longer: A Randomized Clinical Trial. J Natl Med Assoc. 2021 Jun;113(3):278-284. doi: 10.1016/j.jnma.2020.11.016. Epub 2020 Dec 24. PMID: 33349469.
Pastora-Bernal, J. M., Martín-Valero, R., Barón-López, F., Moyano, N. G., & Estebanez-Pérez, M.-J. (2018, Jul). Telerehabilitation after arthroscopic subacromial decompression is effective and not inferior to standard practice: Preliminary results. J Telemed Telecare, 24(6), 428-433.
Kairy, D.; Tousignant, M.; Leclerc, N.; Côté, A.-M.; Levasseur, M.; Researchers, T.T. The Patient’s Perspective of in-Home Telerehabilitation Physiotherapy Services Following Total Knee Arthroplasty. Int. J. Environ. Res. Public Health 2013, 10, 3998-4011.
Richardson, B., Truter, P., & Russell, T. (2017). Physiotherapy assessment and diagnosis of knee via telerehabilitation. J Telemed Telecare, 23(1), 88-95.
Mani, S., Sharma, S., & Singh, D. (2019). Concurrent validity and reliability of telerehabilitation-based physiotherapy assessment of cervical spine in adults with non-specific neck pain. J Telemed Telecare.
Lade, H., McKenzie, S., Steele, L., & Russell, T. (n.d.). Validity and reliability of the assessment and diagnosis of musculoskeletal elbow disorders using telerehabilitation. J Telemed Telecare, 18(7), 413-418.
Bernhardsson, Susanne et al. “Digital physiotherapy assessment vs conventional face-to-face physiotherapy assessment of patients with musculoskeletal disorders: A systematic review.” PloS one vol. 18,3 e0283013. 21 Mar. 2023, doi:10.1371/journal.pone.0283013