Cincinnati VA Medical Center, Cincinnati, Ohio.
Cincinnati VA Medical Center, Cincinnati, Ohio.
J Manipulative Physiol Ther. 2021 Sep;44(7):558-565. doi: 10.1016/j.jmpt.2021.12.003. Epub 2022 Mar 3.
The purpose of this scoping review was to identify information about telehealth and rehabilitation for the evaluation and management of musculoskeletal disorders, patient satisfaction, cost, and access as may be applicable during the COVID-19 pandemic.
We searched MEDLINE for studies published between January 1, 2000, and June 1, 2019. Search terms consisted of MEDLINE medical subject headings and other words relevant to this review, including "telerehabilitation," "musculoskeletal," "telemedicine," "therapy," "chiropractic," "ergonomics," and "exercise." This review targeted studies of people aged 18 years and older with musculoskeletal concerns. Articles on diagnostic tests, effectiveness of treatment, patient satisfaction, access to care, and cost were included.
Eleven studies were included in this review. Interrater reliability and agreement were moderate to high for several assessment procedures for the lower limb, elbow, and low back. Two clinical trials demonstrated that provider and patient simultaneous telehealth were equally as effective as in-office care. Patient and provider satisfaction with telehealth were reported to be equal to or higher than for conventional rehabilitation. We found no studies reporting cost or access.
In the COVID-19 pandemic environment, telehealth is feasible for health care providers to provide rehabilitation services for their patients with various musculoskeletal conditions. Current evidence suggests that for some musculoskeletal disorders, telehealth evaluation may be reliable, treatment may be effective, and patient satisfaction may be good or better than for in-office care. Results from this study may help physiatry, physical therapy, and chiropractic health care providers in their decisions to implement telehealth during and after the COVID-19 pandemic.
本范围综述旨在确定与远程医疗和康复相关的信息,用于评估和管理肌肉骨骼疾病、患者满意度、成本和可及性,这些信息可能适用于 COVID-19 大流行期间。
我们在 MEDLINE 上搜索了 2000 年 1 月 1 日至 2019 年 6 月 1 日期间发表的研究。搜索词包括 MEDLINE 医学主题词和其他与本次综述相关的词,包括“远程康复”、“肌肉骨骼”、“远程医疗”、“治疗”、“整脊”、“工效学”和“运动”。本综述针对 18 岁及以上有肌肉骨骼问题的人群。纳入了关于诊断测试、治疗效果、患者满意度、获得医疗服务的机会和成本的文章。
本综述纳入了 11 项研究。对于下肢、肘部和下背部的几种评估程序,其评估者间可靠性和一致性为中度至高度。两项临床试验表明,提供者和患者同时进行远程医疗与办公室护理同样有效。患者和提供者对远程医疗的满意度报告与传统康复相等或更高。我们没有发现报告成本或可及性的研究。
在 COVID-19 大流行环境下,远程医疗可为医疗服务提供者向各种肌肉骨骼疾病患者提供康复服务提供可行性。目前的证据表明,对于某些肌肉骨骼疾病,远程医疗评估可能是可靠的,治疗可能是有效的,患者满意度可能与办公室护理一样好或更好。本研究的结果可能有助于物理医学、物理治疗和脊椎按摩疗法的医疗服务提供者在 COVID-19 大流行期间及之后决定实施远程医疗。