Case Studies in Physical Therapy: Transitioning a "Hands-On" Approach into a Virtual Platform

Turner, Aideen

doi:10.5195/ijt.2018.6253

Cited by 8 publications

(10 citation statements)

References 10 publications

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“…41 However, telemedicine has been identified as an effective tool to manage the comprehensive care of a patient using Internet-based, realtime video to assess and treat musculoskeletal disorders. 42 Despite the perceived self-limitation of the technology, the accuracy of diagnosis in our study was 90.9%, which was on par with previous research 43 in which 93% of participants had the same diagnosis when conducting a physical therapy assessment face-to-face or via telemedicine. These studies were both completed using cases requiring the physical examination of a sprained ankle, which warrants the need for future investigations relative to orthopedic exams for other more complex regions such as the shoulder and low back.…”

Section: Telemedicine Skillscontrasting

confidence: 40%

The Confidence and Abilities to Assess a Simulated Patient Using Telemedicine

Winkelmann

Eberman

2020

Athletic Training Education Journal

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Context Telemedicine is the practice of providing diagnostic consultations and therapeutic interventions to patients at a distance using some form of technology. Typically, health care students do not have the opportunity to practice telemedicine. Objective To investigate athletic training students' ability to transfer telemedicine skills confidently and accurately in a standardized patient (SP) encounter. Design Single cohort. Setting Simulation center. Patients or Other Participants Fifty-five second-year athletic training students (age = 25 ± 3 years) from 6 professional master's athletic training programs volunteered for the study after a 1-week online learning experience about telemedicine. Intervention(s) We scheduled individual SP encounters that were completed at a distance using telepresence robots. Main Outcome Measure(s) Pre– and post–SP encounter validated confidence assessment and a 50-item content checklist (yes or no) scored by one evaluator. Results During the SP encounter, 87.3% of participants correctly diagnosed the SP actor with a lateral ankle sprain. We identified a significant improvement in confidence (P ≤ .001) for using telemedicine technology. On the content checklist, participants scored poorly in the constructs of data gathering (mean = 7.44 ± 2.36 of 15, 49.58% ± 15.75%) and telemedicine (mean = 6.02 ± 2.74 of 14, 42.99% ± 19.56%), but scored well in the constructs of communication/interpersonal skills (mean = 12.05 ± 2.00 of 15, 80.36% ± 13.36%) and patient education (mean = 4.64 ± 1.06 of 6, 77.27% ± 17.67%). The mean sum score of all constructs on the SP encounter was moderate (30.15 ± 5.79 of 50, 60.29% ± 11.59%). Conclusions Exposure to telemedicine via an SP encounter improved confidence in performing the tech-based evaluation. Athletic training students performed well in demonstrating communication/interpersonal skills and patient education, yet struggled in their data gathering and telemedicine skills. Overall, participants accurately diagnosed a musculoskeletal condition using telemedicine.

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Section: Telemedicine Skillscontrasting

confidence: 40%

The Confidence and Abilities to Assess a Simulated Patient Using Telemedicine

Winkelmann

Eberman

2020

Athletic Training Education Journal

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“…One observational study [ 48 ] and the remaining case studies/series included in this review, investigated the use of telehealth assessments for participants with either low back pain [ 48 , 53 , 75 ], gender health concerns (pelvic dysfunction or post-partum support) [ 44 , 57 ] or cancer care [ 42 ]. Of these studies, one study reported telehealth consultation lengths ranging from 3-21 minutes (mean 8.5 minutes) with consultation time devoted to pain, administrative issues, and actions, ie, bookings and advice on physical activity [ 48 ].…”

Section: Resultsmentioning

confidence: 99%

The utility of physiotherapy assessments delivered by telehealth: A systematic review

et al. 2021

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Background Telehealth use is increasing due to its ability to overcome service access barriers and provide continued care when disease transmission is of concern. However, little is known of the validity, reliability and utility of performing physiotherapy assessments using synchronous forms of telehealth across all physiotherapy practice areas. The aim of this systematic review was to determine the current clinometric value of performing physiotherapy assessments using synchronous forms of telehealth across all areas of physiotherapy practice. Methods A comprehensive search of databases (PubMed/MEDLINE, The Cochrane Library, Embase and EBSCO) was undertaken to identify studies investigating the clinometric value of performing physiotherapy assessments using synchronous forms of telehealth across all physiotherapy practice areas. Following selection, a quality appraisal was conducted using the Brink and Louw or Mixed Methods Appraisal Tool. Evidence regarding validity, reliability and utility of synchronous telehealth physiotherapy assessments was extracted and synthesised using a critical narrative approach. Results Thirty-nine studies conducted in a variety of simulated (n = 15) or real-world telehealth environments (n = 24), were included. The quality of the validity, reliability and utility studies varied. Assessments including range of movement, muscle strength, endurance, pain, special orthopaedic tests (shoulder/elbow), Berg Balance Scale, timed up and go, timed stance test, six-minute walk test, steps in 360-degree turn, Movement Assessment Battery for Children (2 nd Edition), step test, ABILHAND assessment, active straight leg raise, and circumferential measures of the upper limb were reported as valid/reliable in limited populations and settings (many with small sample sizes). Participants appeared to embrace telehealth technology use, with most studies reporting high levels of participant satisfaction. If given a choice, many reported a preference for in-person physiotherapy assessments. Some inconsistencies in visual/auditory quality and challenges with verbal/non-verbal communication methods were reported. Telehealth was considered relatively cost-effective once services were established. Conclusions Performing physiotherapy assessments using synchronous forms of telehealth appears valid and reliable for specific assessment types in limited populations. Further research is needed in all areas of physiotherapy practice, to strengthen the evidence surrounding its clinometric value. Clinicians contemplating using this assessment mode should consider the client/family preferences, assessment requirements, cultural needs, environment, cost considerations, access and confidence using technology. Protocol registration PROSPERO: CRD42018108166.

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“…Six studies were performed in the United States of America. [21][22][23][24][25][26] Four studies were performed in Australia [27][28][29][30] and three in the United Kingdom. [31][32][33] Two studies each were performed in Sweden, 34,35 Spain 36,37 and Canada.…”

Section: Countries Where Studies Were Performedmentioning

confidence: 99%

The use of telephone and video consultations in upper limb musculoskeletal rehabilitation: A scoping review

Maltby,

Underhill,

Woodbridge

2023

Hand Therapy

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Introduction In 2020, the COVID-19 pandemic caused a rapid uptake of virtual consultations (VCs) to minimise disease transmission and for this reason, research into telerehabilitation has been expanding. This review aimed to map and synthesize evidence on the use of VCs in upper limb musculoskeletal rehabilitation, describe key characteristics, and identify gaps in the research. Methods This scoping review investigated synchronous rehabilitation consultations performed over VC. All asynchronous, wearable or pre-recorded technology was excluded. CINAHL Complete, Medline, PEDro, Google Scholar and grey literature sources were searched. Screening and data extraction were done by a single researcher. Frequency counts were used to analyse the data. Results Nineteen studies were identified, with patients with shoulder injury/pain most frequently studied. Most sources (n = 9) used bespoke video programmes. Range of motion (ROM) was the most common assessment (n = 10) and exercise prescription (n = 7) was the most common treatment. Benefits included time and cost savings, maintaining therapeutic relationships and increasing patient independence. Most diagnostic assessments, except joint and nerve tension tests, were found to be reliable and valid. Studies noted increased function in activities, decreased pain and increased ROM after VCs. Limitations included restricted ‘hands-on’ treatment, resource and training concerns and limiting patient factors. Conclusions This review mapped available evidence and identified several gaps in the literature. Further robust research into VCs for hand/wrist disorders, ROM assessment and cost-effectiveness is needed.

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Case Studies in Physical Therapy: Transitioning a "Hands-On" Approach into a Virtual Platform

Cited by 8 publications

References 10 publications

The Confidence and Abilities to Assess a Simulated Patient Using Telemedicine

The Confidence and Abilities to Assess a Simulated Patient Using Telemedicine

The utility of physiotherapy assessments delivered by telehealth: A systematic review

The use of telephone and video consultations in upper limb musculoskeletal rehabilitation: A scoping review

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