The Current Accuracy, Cost-Effectiveness, and Uses of Musculoskeletal Telehealth and Telerehabilitation Services

Abstract

Musculoskeletal conditions are a major contributor to global morbidity. During the COVID-19 pandemic, clinicians needed to rapidly meet the evolving requirements of their patients, which resulted in an increased adoption of telehealth services. This area needs more research, as there is currently a paucity of studies, and telehealth practices are continuing to advance and evolve. This study subsequently aims to evaluate the ethics, health economics, and accuracy of current musculoskeletal telehealth services. This article combines three original studies; a telehealth accuracy systematic review; a cost-effectiveness scoping review; and a biopsychosocial narrative review. These studies were combined into one article. This article concludes that telehealth services achieve an average agreement with in-person assessments of 62% for the knee and 31% for the shoulder and that telerehabilitation services incur average cost savings per patient of £38.57 but that these savings are primarily a result of a reduced need to travel.

Therapeutic Exercise Interventions through Telerehabilitation in Patients with Post COVID-19 Symptoms: A Systematic Review

“…In comparison with traditional rehabilitation, only two studies carried out an analysis of efficacy [31,33], both of which position it as equally effective, and even superior in some parameters such as SGRQ [31]; although more studies are needed on this population, telerehabilitation already has a more than proven efficacy in other pathologies [18,43,44] as well as a much lower cost [45,46] and a good reception by patients [24,47]. These aspects make telerehabilitation a new trend in health sciences and, more specifically, boosted by the COVID-19 pandemic [48].…”

Patient experiences receiving rehabilitation care via telehealth: Identifying opportunities for remote care

“…Decreasing burden for travel related to distance and expense, but also for people with impaired motor function, cognitive difficulties, and/or pain, those who have equipment needs, or those who may rely on caregivers for transportation and help is critical for optimizing telehealth use for needed rehabilitation services and appointments for people with disabilities and chronic conditions. In one study, adoption of telehealth and telerehabilitation for musculoskeletal conditions during the pandemic was associated with cost-savings of £38.57 per patient primarily due to reduced travel needs for visit ( 12 ), and the use of school-based tele-physiatry for children living in rural and underserved communities in Northern California resulted in an average cost savings of $100 per clinic to the payer due to reducing physician mileage reimbursement ( 30 ). Future health economic studies of telehealth for physiatry and rehabilitation services will be needed.…”

“…Furthermore, telemedicine for physiatry would be beneficial to minimize COVID-19 exposure risk in often medically vulnerable populations. Since the onset of COVID-19 in 2020, several studies describe the benefits of telemedicine in rehabilitation populations and patient and/or provider satisfaction, primarily for outpatient sports and musculoskeletal issues in adults and children (7)(8)(9)(10)(11)(12)(13)(14), spinal cord injury (15)(16)(17), cancer rehabilitation (18), and chronic pain (19)(20)(21). With the COVID-19 pandemic, there was a growing need for medical centers to convert traditional, in-person patient encounters to telehealth formats.…”

“…With the COVID-19 pandemic, there was a growing need for medical centers to convert traditional, in-person patient encounters to telehealth formats. Published reports document this change in outpatient and inpatient rehabilitation settings and various locations, e.g., United States, Europe, and Asia (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). To date, less is known about the benefits or experiences in physiatry practices for other neurological conditions, in coordinated multidisciplinary team settings, or in comparisons across different clinical rehabilitation populations.…”

Can you be a manual therapist without using your hands?

“…The use of evidence-based information can also be seen as a facilitator since it improves knowledge, self-efficacy and self-management [ 31 ]. There is also emerging evidence that telehealth can reduce costs; however, savings may not apply to healthcare consultations but rather be related to time and travel and time off work or out of daily duties while travelling [ 39 ]. Table 1 presents common challenges in telehealth with potential solutions.…”