Digital’s role in the treatment mix
A new report shows virtual is just as effective as face to face, writes Barry Nguyen.
Recently we have seen an emerging number of studies that support virtual physiotherapy; for example, an NPJ Digital Medicine study published in January suggested health apps add value to patient care while used in clinical workflows.
However, there is a limited amount of evidence supporting a small number of apps for defined clinical scenarios, despite a high adoption rate with consumers.
In addition, a recent Australian Bond University study looking at six systematic reviews found the overall quality of evidence for app effectiveness limits the prescribability of health apps.
Nonetheless, it appears that telehealth physiotherapy is showing promising outcomes with a stronger and growing evidence base.
It is more obvious now during the COVID-19 pandemic that at the very least, patients are reportedly very satisfied with digital physiotherapy services compared to face-to-face delivery methods.
One of the largest comparative observation studies so far on virtual physiotherapy conducted in the UK, with a sample size of more than 27,000 participants, was based on more than 12 months of treatments.
Ascenti, an independent provider of virtual physiotherapy services, captured data on patients’ openness to virtual treatment, pain improvements and outcome satisfaction.
This study concluded that virtual physiotherapy can be just as effective or in some cases more effective than face-to-face consultations, in particular for the majority of non-complex musculoskeletal conditions.
This study defines ‘virtual physiotherapy’ services as:
- digital triage—patients answer a series of survey questions online to determine the most appropriate care pathway
- remote consultations—physiotherapists delivering services by video through prescription of video content, advice and education
- self-management—advice, education and digital exercise prescriptions through an app, which also tracks patient progress.
While many think physiotherapy is predominantly about hands- on manual therapy, this study challenges this notion.
It essentially argues that clinicians use virtual physiotherapy in addition to exercise prescription, and guide their patients through self-treatment techniques such as self-joint mobilisation and self-trigger point release techniques, substituting the traditional face-to-face physiotherapy approach.
Nonetheless, the report comprehensively discusses a balanced view of the advantages and disadvantages of virtual physiotherapy.
A key point to note is that despite the benefit of convenience offered by virtual physiotherapy, there is the potential compromise of value that is associated with therapeutic touch, and reduced trust on the part of some patients—the latter might prove to be the greater challenge to overcome.
The report also highlights the key to success of virtual physiotherapy services:
- virtual physiotherapy is not the best way to treat all musculoskeletal conditions and in-person treatment may be the better option
- in many cases, the best delivery method combines both virtual and in-person treatment, which can improve treatment compliance
- some patients are more self-motivated by the extra accountability associated with virtual physiotherapy consultations while others may be more comfortable with the traditional face-to-face approach, and therefore achieve better outcomes
- it is also dependent on the clinician’s skills and experience— some clinicians are more tech savvy and much better at judging and managing non-verbal cues via video, while others excel as manual therapists in a traditional in-person environment, and produce better outcomes.
This study reinforces the important role that digital physiotherapy will play in healthcare post-COVID-19 pandemic.
Because patients will likely expect it in some form from now on, it appears that telehealth physiotherapy is here to stay, which highlights the importance of physiotherapists improving their clinical practices through leveraging technologies.
Clearly the future of physiotherapy should incorporate virtual services as part of the treatment mix, depending on patients’ and clinicians’ preferences and experiences, not to mention reimbursement models.
>> Check out the study report here.
Disclaimer: This material is intended for general information pur- poses only and does not constitute legal advice or meet the specific needs of your clinical context.
© Copyright 2018 by Australian Physiotherapy Association. All rights reserved.