Outcomes of Telehealth Physical Therapy Provided Using Real-Time, Videoconferencing for Patients With Chronic Low Back Pain: A Longitudinal Observational Study

Julie M Fritz; Kate I Minick; Gerard P Brennan; Terrence McGee; Elizabeth Lane; Richard L Skolasky; Anne Thackeray; Tyler Bardsley; Stephen T Wegener; Stephen J Hunter

doi:10.1016/j.apmr.2022.04.016

Outcomes of Telehealth Physical Therapy Provided Using Real-Time, Videoconferencing for Patients With Chronic Low Back Pain: A Longitudinal Observational Study

Arch Phys Med Rehabil. 2022 Oct;103(10):1924-1934. doi: 10.1016/j.apmr.2022.04.016. Epub 2022 Jun 3.

Authors

Affiliations

¹ Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, Utah. Electronic address: julie.fritz@utah.edu.
² Rehabilitation Services, Intermountain Healthcare, Salt Lake City, Utah.
³ Johns Hopkins Hospital Rehabilitation Therapy Services, Baltimore, Maryland.
⁴ Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
⁵ Division of Epidemiology, University of Utah, Salt Lake City, Utah.
⁶ Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland.

PMID: 35667399
DOI: 10.1016/j.apmr.2022.04.016

Abstract

Objective: To describe the feasibility of an evidence-based physical therapy (PT) program for persons with chronic low back pain (LBP) originally designed for in-person delivery, adapted for telehealth using videoconferencing.

Design: Prospective, longitudinal cohort.

Setting: Three health care systems in the United States.

Participants: Adults, aged 18-64 years (N=126), with chronic LBP recruited from August through December 2020.

Intervention: Up to 8 weekly sessions of telehealth PT.

Main outcome measures: Follow-up assessments were 10 and 26 weeks after baseline. Participant outcomes collected were the Oswestry Disability Index, Patient-Reported Outcomes Measurement Information System-29 health domains, and pain self-efficacy. Implementation outcomes included acceptability, adoption, feasibility, and fidelity assessed using participant surveys and compliance with session attendance.

Results: We enrolled 126 participants (mean age, 51.5 years; 62.7% female). Baseline perceptions about telehealth were generally positive. Eighty-eight participants (69.8%) initiated telehealth PT, with a median of 5 sessions attended. Participants in telehealth PT were generally satisfied (76.3%), although only 39.5% perceived the quality equal to in-person PT. Telehealth PT participants reported significant improvement in LBP-related disability, pain intensity, pain interference, physical function, and sleep disturbance at 10- and 26-week follow-ups.

Conclusions: The findings generally support the feasibility of telehealth PT using videoconferencing. Implementation and participant outcomes were similar to in-person PT as delivered in the participating health care systems. We identified barriers that may detract from the patient experience and likelihood of benefitting from telehealth PT. More research is needed to optimize and evaluate the most effective strategies for providing telehealth PT for patients with chronic LBP.

Trial registration: ClinicalTrials.gov NCT05103462.

Keywords: Low back pain; Physical therapy modalities; Rehabilitation; Telemedicine; Telerehabilitation.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Chronic Pain* / rehabilitation
Female
Humans
Low Back Pain* / rehabilitation
Male
Middle Aged
Physical Therapy Modalities
Prospective Studies
Telemedicine*
Videoconferencing

Associated data

ClinicalTrials.gov/NCT05103462