Is Telerehabilitation a Viable Option for People With Low Back Pain? Associations Between Telerehabilitation and Outcomes During the COVID-19 Pandemic

Abstract

Objective The aims of this study were to examine associations between frequency of telerehabilitation and outcomes of functional status, number of visits, and patient satisfaction during COVID-19 and to compare functional status outcomes by telerehabilitation delivery mode for patients with low back pain. Methods Propensity score matching as used to match episodes of care with or without telerehabilitation exposure by the probability of receiving telerehabilitation. Functional status, visits, and satisfaction were compared for patients without telerehabilitation and those who received care by telerehabilitation for “any”, “few”, “most”, or “all” frequencies (4 matched samples), and functional status was compared for patients receiving synchronous, asynchronous, and mixed telerehabilitation modes (3 matched samples). Standardized differences were used to compare samples before and after matching. Outcomes between matched samples were compared using z tests with 95% CI. Results The sample consisted of 91,117 episodes of care from 1398 clinics located in 46 states (58% women; mean age = 55 [SD = 18]). Of those, only 5013 episodes (5.5%) involved any amount of telerehabilitation. All standardized differences between matched samples were < 0.1. There was no significant difference in functional status points (range = 0–100, with higher representing better functional status) between matched samples, except for episodes that had few (−1.7) and all (+2.0) telerehabilitation frequencies or that involved the asynchronous (−2.6) telerehabilitation mode. These point differences suggest limited clinical importance. Episodes with any telerehabilitation frequency involved significantly fewer visits (0.7 to 1.3) than episodes with no telerehabilitation, except that those with the “most” telerehabilitation frequency had nonsignificantly fewer visits (0.6). A smaller proportion of patients with telerehabilitation (−4.0%) than of patients with no telerehabilitation (−5.0%) reported being very satisfied with treatment results, except for those with the “All” telerehabilitation frequency. Conclusions A positive association between telerehabilitation and rehabilitation outcomes was observed, with a trend for better functional status outcomes and fewer visits when all care was delivered through telerehabilitation. Satisfaction tended to be lower with telerehabilitation use.

The Impact of Personality Traits on Patient Satisfaction after Telerehabilitation: A Comparative Study of Remote and Face-to-Face Musculoskeletal Rehabilitation during COVID-19 Lockdown

“…In this study, we demonstrated a relationship between personality and patient satisfaction. Previous studies have suggested a possible link between patient satisfaction, higher adherence, and the clinical effectiveness of telerehabilitation [ 38 , 39 , 40 ]. Personality may indirectly affect clinical effectiveness through the mediating mechanism of patient satisfaction, which should be explored in future research.…”

The effectiveness of telerehabilitation‐based exercise combined with pain neuroscience education for patients with facet joint arthrosis: A randomized controlled study

“…The authors indicated that telerehabilitation and in‐person physiotherapy in patients with LBP had comparable results and better outcomes than the control group and patients in waiting list. More recently, Werneke et al (2022) argued that physiotherapy and rehabilitation delivered with synchronous (simultaneously) telerehabilitation were equally effective and more efficient than in‐person physiotherapy and rehabilitation. In the present study, we used telerehabilitation due to the Covid‐19 pandemic.…”

Reliability of tele-assessment of five repetition sit to stand and timed up and go tests in patients with non- specific chronic low back pain

“…NSLBP is one of the most burdensome health problems worldwide, associated with functional disability, incapacity for work and deteriorating quality of life, requiring a multidisciplinary rehabilitation approach [20,1]. Nowadays, tele-rehabilitation has come to the forefront in order to reach all segments of the society with rehabilitation practices in individuals with low back pain [21]. This situation also increases the importance of tele-assessments [22].…”