What is Telehealth, Telerehabilitation or Virtual Physiotherapy?
Telehealth is the delivery of healthcare services remotely via online web based services and applications. Physiotherapy interventions delivered via telerehabilitation are shown to be equally, if not more effective than in-person (1) (2) (3).
What are the benefits of Telerehabilitation?
1) Improved access to physiotherapy
2) Decreased cost and time related to travel
3) Increased adherence to treatment plans
4) Decreased interruptions in treatment plans by eliminating schedule and travel barriers
What is the research around Virtual Physiotherapy?
Individuals receiving 2 months of telemedicine physiotherapy post shoulder joint replacement improved significantly more in terms of pain and vitality than those receiving traditional physiotherapy (1)
Individuals receiving physiotherapy via telemedicine after total knee replacements showed no difference in pain, stiffness and function as those receiving in person physiotherapy (2)
Individuals with chronic heart failure receiving physiotherapy exercise programs via telerehabilitation showed no inferior benefit to those receiving traditional in-person exercise programs. Additionally, those in the telerehabilitation group had significant higher attendance rates (3)
Physiotherapy prescribed exercises and pain education delivered over the internet was more effective for chronic knee pain than internet based education material only (4)
Internet delivered pelvic floor muscle training for stress urinary incontinence provided significant and clinically important improvements in symptoms and quality of life (5)
What type of Physiotherapy works well via Telehealth?
1) Persistent/chronic pain management including chronic low back pain
2) Exercise program monitoring, follow up and progression
3) Activity modification and education
4) Pelvic health education and exercise prescription
5) Corporate wellness and education seminars
1) Eriksson, L., Lindström, B., Gard, G., & Lysholm, J. (2009). Physiotherapy at a distance: A controlled study of rehabilitation at home after a shoulder joint operation. Journal of Telemedicine and Telecare,15(5), 215-220. doi:10.1258/jtt.2009.081003
2) Spangehl, M. J. (2015). Is It Time for Telerehabilitation to Go Mainstream? The Journal of Bone and Joint Surgery-American Volume,97(14). doi:10.2106/jbjs.o.00540
3) Hwang, R., Bruning, J., Morris, N. R., Mandrusiak, A., & Russell, T. (2017). Home-based telerehabilitation is not inferior to a centre-based program in patients with chronic heart failure: A randomised trial. Journal of Physiotherapy,63(2), 101-107. doi:10.1016/j.jphys.2017.02.017
4) Bennell, K. L., Nelligan, R., Dobson, F., Rini, C., Keefe, F., Kasza, J., Hinman, R. S. (2017). Effectiveness of an Internet-Delivered Exercise and Pain-Coping Skills Training Intervention for Persons With Chronic Knee Pain. Annals of Internal Medicine,166(7), 453. doi:10.7326/m16-1714
5) Sjöström, M., Umefjord, G., Stenlund, H., Carlbring, P., Andersson, G., & Samuelsson, E. (2015). Internet-based treatment of stress urinary incontinence: 1- and 2-year results of a randomized controlled trial with a focus on pelvic floor muscle training. BJU International,116(6), 955-964. doi:10.1111/bju.13091