In 2020, the COVID-19 pandemic caused a rapid uptake of virtual consultations (VCs) to minimise disease transmission and for this reason, research into telerehabilitation has been expanding. This review aimed to map and synthesize evidence on the use of VCs in upper limb musculoskeletal rehabilitation, describe key characteristics, and identify gaps in the research.
Methods
This scoping review investigated synchronous rehabilitation consultations performed over VC. All asynchronous, wearable or pre-recorded technology was excluded. CINAHL Complete, Medline, PEDro, Google Scholar and grey literature sources were searched. Screening and data extraction were done by a single researcher. Frequency counts were used to analyse the data.
Results
Nineteen studies were identified, with patients with shoulder injury/pain most frequently studied. Most sources (n = 9) used bespoke video programmes. Range of motion (ROM) was the most common assessment (n = 10) and exercise prescription (n = 7) was the most common treatment. Benefits included time and cost savings, maintaining therapeutic relationships and increasing patient independence. Most diagnostic assessments, except joint and nerve tension tests, were found to be reliable and valid. Studies noted increased function in activities, decreased pain and increased ROM after VCs. Limitations included restricted ‘hands-on’ treatment, resource and training concerns and limiting patient factors.
Conclusions
This review mapped available evidence and identified several gaps in the literature. Further robust research into VCs for hand/wrist disorders, ROM assessment and cost-effectiveness is needed.
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References
1.
HorsleySSchockGGronaSL, et al.Use of real-time videoconferencing to deliver physical therapy services: A scoping review of published and emerging evidence. J Telemed Telecare2020; 26(10): 581–589.
2.
JesusTSLandryMDDussaultG, et al.Human resources for health (and rehabilitation): Six Rehab-Workforce Challenges for the century. Hum Resour Health2017; 15(1): 1–2.
RussellT. Physical rehabilitation using telemedicine. J Telemed Telecare2007; 13(5): 217–220.
6.
GregoryWJBurchettSMcCrumC. National survey of the current clinical practices of the UK rheumatology physiotherapists: A short report. Muscoskel Care2021; 19(1): 136–141.
HaileyDRoineROhinmaaA, et al.Evidence of benefit from telerehabilitation in routine care: a systematic review. J Telemed Telecare2011; 17(6): 281–287.
9.
KairyDLehouxPVincentC, et al.A systematic review of clinical outcomes, clinical process, healthcare utilization and costs associated with telerehabilitation. Disabil Rehabil2009; 31(6): 427–447.
10.
KeilLCarrK. Telerehabilitation: The impact on occupational therapy interventions [dissertation on the internet]. Ann Arbor: The College of St. Scholastica, 2012.
11.
CottrellMAGaleaOAO’LearySP, et al.Real-time telerehabilitation for the treatment of musculoskeletal conditions is effective and comparable to standard practice: a systematic review and meta-analysis. Clin Rehabil2017; 31(5): 625–638.
12.
GronaSLBathBBuschA, et al.Use of videoconferencing for physical therapy in people with musculoskeletal conditions: A systematic review. J Telemed Telecare2018; 24(5): 341–355.
13.
Pastora-BernalJMMartín-ValeroRBarón-LópezFJ, et al.Evidence of benefit of telerehabitation after orthopedic surgery: a systematic review. J Med Internet Res2017; 19(4): 1–12.
14.
PetersMGodfreyCMcInerneyP, et al.Chapter 11: Scoping reviews: JBI; 2020 version. Available from:https://synthesismanual.jbi.global. DOI: 10.46658/JBIMES-20-12.
15.
TriccoACLillieEZarinW, et al.PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med2018; 169(7): 467–473.
16.
PetersMDJGodfreyCMKhalilH, et al.Guidance for conducting systematic scoping reviews. JBI Evidence Implementation2015; 13(3): 141–146.
17.
SucharewH. Methods for research evidence synthesis: the scoping review approach. J Hosp Med2019; 14(7): 416.
18.
ArkseyHO'MalleyL. Scoping studies: towards a methodological framework. Int J Soc Res Methodol2005; 8(1): 19–32.
UnsworthC. Writing systematic, scoping, and app reviews: summarising and appraising best evidence. Br J Occup Ther2020; 83(5): 277–284.
21.
IvyCCDoerrerSNaughtonN, et al.The impact of COVID-19 on hand therapy practice. Journal of Hand Therapy [Internet]2021; 35: 523–536. DOI: 10.1016/j.jht.2021.01.007.
22.
MehtaSPKendallKMReasorCM. Virtual assessments of knee and wrist joint range motion have comparable reliability with face-to-face assessments. Muscoskel Care2021; 19(2): 208–216.
23.
PalmKBBlazarPEMannaJC, et al.Feasibility, effectiveness and patient satisfaction of telerehabilitation after thumb carpometacarpal arthroplasty and reverse total shoulder arthroplasty: A pilot study. J Telemed Telecare2021; 0(0): 1–9.
24.
PrigancVNaughtonNDoerrerS, et al.A follow up survey on the impact of COVID-19 on hand therapy practice. Journal of Hand Therapy [Internet]2021; 36: 121–132. DOI: 10.1016/j.jht.2021.07.001.
25.
TurnerA. Case Studies in physical therapy: transitioning a “Hands-On” approach into a virtual platform. Int J Telerehabilitation2018; 10(1): 37–50.
26.
YoungSWYoungTWMacDonaldCW. Physical therapist identification of an undetected rotator cuff tear via a telehealth evaluation: A Case Report. JOSPT Cases2021; 1(1): 29–33.
27.
LadeHMcKenzieSSteeleL, et al.Validity and reliability of the assessment and diagnosis of musculoskeletal elbow disorders using telerehabilitation. J Telemed Telecare2012; 18(7): 413–418.
28.
MalliarasPCridlandKHopmansR, et al.Internet and Telerehabilitation-Delivered Management of Rotator Cuff–Related Shoulder Pain (INTEL Trial): randomized controlled pilot and feasibility trial. JMIR mHealth and uHealth [Internet]2020; 8(11): 1–18. Available from:http://mhealth.jmir.org/2020/11/e24311/
29.
SteeleLLadeHMcKenzieS, et al.Assessment and diagnosis of musculoskeletal shoulder disorders over the internet. International journal of telemedicine and applications [Internet]2012; 2012: 1–8.
30.
WorboysTBrassingtonMWardEC, et al.Delivering occupational therapy hand assessment and treatment sessions via telehealth. J Telemed Telecare2018; 24(3): 185–192.
31.
GilbertAWJaggiAMayCR. What is the acceptability of real time 1:1 videoconferencing between clinicians and patients for a follow-up consultation for multi-directional shoulder instability?Shoulder Elbow2019; 11(1): 53–59.
32.
McMullenE. Use of audiovisual equipment (SKYPE) for the treatment of hand injuries for remote consultations. Hand Ther2012; 17(2): 42–46.
33.
McMullenERobsonMBrewinMP, et al.Clinical decision making in the provision of audiovisual care for upper limb trauma: a survey of UK experiences. Hand Therapy [Internet]; 0(0): 1–9.
34.
ErikssonLLindströmBGardG, et al.Physiotherapy at a distance: a controlled study of rehabilitation at home after a shoulder joint operation. J Telemed Telecare2009; 15(5): 215–220.
35.
ErikssonLLindströmBEkenbergL. Patients' experiences of telerehabilitation at home after shoulder joint replacement. J Telemed Telecare2011; 17(1): 25–30.
36.
Pastora-BernalJMMartín-ValeroRBarón-LópezFJ, et al.Telerehabilitation after arthroscopic subacromial decompression is effective and not inferior to standard practice: Preliminary results. J Telemed Telecare2018a; 24(6): 428–433.
37.
Pastora-BernalJMMartín-ValeroRBarón-LópezFJ. Cost analysis of telerehabilitation after arthroscopic subacromial decompression. J Telemed Telecare2018b; 24(8): 553–559.
38.
SzekeresMValdesK. Virtual health care & telehealth: Current therapy practice patterns. Journal of Hand Therapy [Internet]2020; 35: 124–130. DOI: 10.1016/j.jht.2020.11.004.
39.
TousignantMGiguèreA-MMorinM, et al.In-home telerehabilitation for proximal humerus fractures: a pilot study. Int J Telerehabilitation2015; 6(2): 31–38.
40.
ThomasK. How to plan and execute a telehealth physical therapy session: Don't Just Natter, Make it Matter. Co-Kinetic Journal2020; 86: 22–29.
41.
Proton TechnologiesAG. What is GDPR, the EU's new data protection law?[Available from:https://gdpr.eu/what-is-gdpr/(2022).
42.
DijkstraHPErgenEHoltzhausenL, et al.Remote assessment in sport and exercise medicine (SEM): a narrative review and teleSEM solutions for and beyond the COVID-19 pandemic. Br J Sports Med2020; 54(19): 1162–1167.
43.
FrankoOIZurakowskiDDayCS. Functional disability of the wrist: direct correlation with decreased wrist motion. J Hand Surg2008; 33(4): 485.
44.
HayesKWaltonJRSzomorZL, et al.Reliability of five methods for assessing shoulder range of motion. Aust J Physiother2001; 47(4): 289–294.
45.
HudakPLAmadioPCBombardierC, et al.Development of an upper extremity outcome measure: The DASH (disabilities of the arm, shoulder, and head). Am J Ind Med1996; 29(6): 602–608.
GilbertAWJonesJJaggiA, et al.Use of virtual consultations in an orthopaedic rehabilitation setting: how do changes in the work of being a patient influence patient preferences? A systematic review and qualitative synthesis. BMJ Open2020; 10(9): e036197.
48.
CottrellMJuddPComansT, et al.Comparing fly-in fly-out and telehealth models for delivering advanced-practice physiotherapy services in regional Queensland: an audit of outcomes and costs. J Telemed Telecare2021; 27(1): 32–38.
49.
NelsonMRussellTCrossleyK, et al.Cost-effectiveness of telerehabilitation versus traditional care after total hip replacement: A trial-based economic evaluation. J Telemed Telecare2019; 0(0): 1–7.
50.
TousignantMMoffetHNadeauS, et al.Cost Analysis of In-Home Telerehabilitation for Post-Knee Arthroplasty. J Med Internet Res2015; 17(3): e83.
51.
ManiSSharmaSOmarB, et al.Validity and reliability of Internet-based physiotherapy assessment for musculoskeletal disorders: a systematic review. J Telemed Telecare2017; 23(3): 379–391.
52.
HinmanRSNelliganRKBennellKL, et al.Sounds a bit crazy, but it was almost more personal:” a qualitative study of patient and clinician experiences of physical therapist-prescribed exercise for knee osteoarthritis via skype. Arthritis Care Res2017; 69(12): 1834–1844.
53.
LawfordBJBennellKLKaszaJ, et al.Physical therapists’ perceptions of telephone- and internet video-mediated service models for exercise management of people with osteoarthritis. Arthritis Care Res2018; 70(3): 398–408.
54.
MalliarasPMerolliMWilliamsCM, et al.‘It's not hands-on therapy, so it's very limited’: Telehealth use and views among allied health clinicians during the coronavirus pandemic. Musculoskeletal Science and Practice [Internet]2021; 52: 102340, DOI: 10.1016/j.msksp.2021.102340.
55.
KairyDTousignantMLeclercN, et al.The patient's perspective of in-home telerehabilitation physiotherapy services following total knee arthroplasty. Int J Environ Res Publ Health2013; 10(9): 3998–4011.
56.
LawfordBJDelanyCBennellKL, et al.I was really sceptical...But it worked really well”: a qualitative study of patient perceptions of telephone-delivered exercise therapy by physiotherapists for people with knee osteoarthritis. Osteoarthritis Cartilage2018; 26(6): 741–750.
57.
McMullenEJRobsonMValandP, et al.Defining clinical decision making in the provision of audio-visual outpatient care for acute upper limb trauma services: A review of practice. J Plast Reconstr Aesthetic Surg2021; 74(2): 407–447.
58.
TurollaARossettiniGVicecontiA, et al.Musculoskeletal physical therapy during the COVID-19 pandemic: is telerehabilitation the Answer?Phys Ther2020; 100(8): 1260–1264.
59.
CottrellMAHillAJO'LearySP, et al.Clinicians’ perspectives of a novel home-based multidisciplinary telehealth service for patients with chronic spinal pain. Int J Telerehabilitation2018; 10(2): 81–88.
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