Harnessing technology to deliver care by physical therapists for people with persistent joint pain: Telephone and video‐conferencing service models

Abstract

Purpose The burden of musculoskeletal conditions, particularly osteoarthritis (OA), is expected to increase in coming decades as the world's population ages, and obesity rates continue to rise. Self‐management via lifestyle interventions, such as exercise and physical activity, is integral to minimizing pain and maintaining physical function, yet access to qualified health professionals for evidence‐based advice and support is difficult for many people. This article discusses how technology provides new opportunities for delivering physiotherapy services remotely to people with persistent joint pain, through telephone, and internet‐mediated video conferencing. Methods The evidence for effectiveness of such service models is reviewed. Key challenges to implementation are discussed, and future directions for research in the field are highlighted. Results There is emerging evidence that the provision of care via telephone and internet‐mediated video technologies is effective for, and acceptable to, people with OA. Advantages include its convenience and accessibility, as well as the “hands‐off” nature of consultations. Challenges include patient safety and privacy and workforce willingness and capacity to deliver care via non‐traditional methods. Conclusions Using technology to deliver physiotherapy services to people with OA is feasible and acceptable to users; however, further research is required to expand the evidence‐base for remotely‐delivered physiotherapy service models.

Implementation of telerehabilitation in response to COVID-19: Lessons learnt from neurorehabilitation clinical practice and education

“…Physiotherapists had to enhance their communication skills rapidly, and appreciate and attend to the therapeutic relationship. These are aspects of practice that are often taken for granted (Hinman et al, 2019), yet have been shown to be important factors in patient experience and outcomes (Pinto et al, 2012). Reliance on patient self-report has also challenged our understandings of whose knowledge is privileged.…”

“…Reliance on patient self-report has also challenged our understandings of whose knowledge is privileged. The unintended impact of telerehabilitation was a focus on self-management, and enhancing people's capability and confidence to self-manage (Bridges Self Management, 2020; Hinman et al, 2019;Lawford et al, 2019), areas emphasised within practice guidelines yet not consistently addressed well in clinical practice (Mudge et al, 2014). Together, these factors show how telerehabilitation can open up different ways of thinking about and doing neurorehabilitation.…”

“…This may reflect underlying beliefs that our movement observation and physical assessment skills are more reliable than the patient's account of their experiences or functioning. However, this is not supported by evidence (Hinman et al, 2019). Additionally, therapists should be reassured by evidence from musculoskeletal practice which suggests that diagnostic accuracy in telerehabilitation assessment is equivalent to in-person assessment (Richardson et al, 2017;Russell et al, 2010).…”

“…The rehabilitative emphasis shifted to task-specific training, exercise rehabilitation, and activity promotion. It often involved a coaching approach, with greater emphasis on problem-solving, patient empowerment, and education; these approaches all helped build capability for selfmanagement (Hinman et al, 2019;Lawford et al, 2019). This shift from "doing to" to "working with" the person required therapists to seek out, rely on and respond to the patient's expertise.…”

Community-based online survey on seeking care and information for lower limb pain and injury in Australia: an observational study

“…Spatial distribution of healthcare providers, transport infrastructure and better local access need to be considered for both urban and regional areas. Increased telehealth services 33 or scaling up current services may be a solution to this issue.…”