Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, Utah.
Rehabilitation Services, Intermountain Healthcare, Salt Lake City, Utah.
Arch Phys Med Rehabil. 2022 Oct;103(10):1924-1934. doi: 10.1016/j.apmr.2022.04.016. Epub 2022 Jun 3.
To describe the feasibility of an evidence-based physical therapy (PT) program for persons with chronic low back pain (LBP) originally designed for in-person delivery, adapted for telehealth using videoconferencing.
Prospective, longitudinal cohort.
Three health care systems in the United States.
Adults, aged 18-64 years (N=126), with chronic LBP recruited from August through December 2020.
Up to 8 weekly sessions of telehealth PT.
Follow-up assessments were 10 and 26 weeks after baseline. Participant outcomes collected were the Oswestry Disability Index, Patient-Reported Outcomes Measurement Information System-29 health domains, and pain self-efficacy. Implementation outcomes included acceptability, adoption, feasibility, and fidelity assessed using participant surveys and compliance with session attendance.
We enrolled 126 participants (mean age, 51.5 years; 62.7% female). Baseline perceptions about telehealth were generally positive. Eighty-eight participants (69.8%) initiated telehealth PT, with a median of 5 sessions attended. Participants in telehealth PT were generally satisfied (76.3%), although only 39.5% perceived the quality equal to in-person PT. Telehealth PT participants reported significant improvement in LBP-related disability, pain intensity, pain interference, physical function, and sleep disturbance at 10- and 26-week follow-ups.
The findings generally support the feasibility of telehealth PT using videoconferencing. Implementation and participant outcomes were similar to in-person PT as delivered in the participating health care systems. We identified barriers that may detract from the patient experience and likelihood of benefitting from telehealth PT. More research is needed to optimize and evaluate the most effective strategies for providing telehealth PT for patients with chronic LBP.
描述为面对面交付而设计的循证物理治疗（PT）计划适应远程医疗使用视频会议的可行性。
前瞻性、纵向队列研究。
美国的三个医疗保健系统。
年龄在 18-64 岁之间（N=126）的慢性腰痛患者，于 2020 年 8 月至 12 月招募。
最多 8 次每周的远程健康 PT。
随访评估分别在基线后 10 周和 26 周进行。收集的参与者结果包括 Oswestry 残疾指数、患者报告的结果测量信息系统-29 个健康领域以及疼痛自我效能。采用参与者问卷调查和对参会出勤率的遵守情况评估了实施结果，包括可接受性、采用、可行性和保真度。
我们共招募了 126 名参与者（平均年龄为 51.5 岁；62.7%为女性）。对远程健康的初步看法普遍较为积极。88 名参与者（69.8%）开始远程健康 PT，中位数为 5 次就诊。远程健康 PT 的参与者总体满意度较高（76.3%），尽管只有 39.5%认为质量与面对面 PT 相同。远程健康 PT 参与者在 10 周和 26 周随访时报告腰痛相关残疾、疼痛强度、疼痛干扰、身体功能和睡眠障碍显著改善。
这些发现总体上支持使用视频会议进行远程健康 PT 的可行性。实施和参与者的结果与参与医疗保健系统中提供的面对面 PT 相似。我们确定了可能会影响患者体验和从远程健康 PT 中获益的可能性的障碍。需要进一步研究以优化和评估为慢性腰痛患者提供远程健康 PT 的最有效策略。
