Effect of telerehabilitation assessment for adults with musculoskeletal conditions on access to care beyond the COVID-19 pandemic: A retrospective case-control analysis.

BACKGROUND

Musculoskeletal (MSK) conditions are the leading cause of disability worldwide. In MSK care, access to physical therapy is a major issue. The effectiveness of telerehabilitation phone assessment in improving access to care for MSK conditions has not yet been established in Saudi Arabia.

PURPOSE

To compare the effect of using a telerehabilitation phone with face-to-face care initial assessment on access to care, number of sessions and goals achievement at discharge.

METHODS

This is a retrospective unmatched case-control analysis of a total of 724 Epic Electronic Medical Records guided by the Evidence standards framework for digital health technologies. Closed referrals from January 1st, 2022, to August 4th, 2022, for adults referred to Physical Therapy for MSK conditions were included. Participants who received a phone assessment were compared to those who received face-to-face care. The t-test was used to compare the means of the lead time, days to second appointment and number of treatment sessions. Univariate logistic regression was conducted to obtain the odds ratio of the outcome factors in the phone group. Statistical significance was set at p ≤ .05. Additionally,we compared the percentage of goal achievement at discharge.

RESULTS

The lead time in days was significantly lower for the phone group (3.82 ± 5.36) compared to the face-to-face group (15.65 ± 17.71) p < 0.0001. Longer lead times from referral to first appointment were less likely to be a phone appointment and more likely to be a face-to-face appointment p < 0.001. However, the time from the first to the second appointment was significantly longer for the phone group p<0.0001. There was no significant difference in the number of appointments between both groups. The majority of the patients in both groups achieved all therapy goals (over 80% for phone and over 75% for face-to-face).

CONCLUSION

Initial telerehabilitation phone assessments compared to face-to-face care were associated with improved access to care, and there was no difference in the number of therapy sessions associated with achieving treatment goals. Future research is needed to determine the clinical effectiveness of phone initial assessments in the management of musculoskeletal conditions.