Telerehabilitation After Musculoskeletal Injury: Outcome Equivalence, Dropout and the Patients It Excludes
DOI:
https://doi.org/10.5281/zenodo.22549197Keywords:
Telerehabilitation, Musculoskeletal injury, Total knee arthroplasty, Digital divide, Health equity, Rehabilitation outcomesAbstract
Telerehabilitation for musculoskeletal injury, particularly after total knee and hip arthroplasty, has
accumulated a substantial randomised trial evidence base showing outcomes broadly equivalent to
in-person rehabilitation on standard function and pain measures. This equivalence finding, however, sits
alongside two less frequently emphasised patterns: reported dropout rates that are somewhat higher in
several telerehabilitation trials than in-person comparators, and a digital-access and digital-literacy
divide that appears to systematically underrepresent or exclude older patients, patients with limited
digital literacy or home broadband access, and patients with limited proficiency in the platform's
operating language from the trial populations equivalence claims are drawn from. This review
synthesises the randomised trial, dropout, and digital-equity literature relevant to telerehabilitation after
musculoskeletal injury, examining what the equivalence evidence does and does not tell clinicians about
who telerehabilitation actually serves well.
References
Cottrell MA, Galea OA, OLeary SP, Hill AJ, Russell TG. "Real-time telerehabilitation for the treatment of musculoskeletal conditions is effective and comparable to standard practice: a systematic review and meta-analysis". Clin Rehabil 31(2017):625-638.
Cottrell MA, Russell TG. "Telehealth for musculoskeletal physiotherapy". Musculoskelet Sci Pract 48(2020):102193.
Bini SA, Mahajan J. "Clinical outcomes of remote asynchronous telerehabilitation are equivalent to traditional therapy following total knee arthroplasty: a randomized control study". J Telemed Telecare 23(2017):239-247.
Moffet H, Tousignant M, Nadeau S, et al. "In-Home Telerehabilitation Compared with Face-to-Face Rehabilitation After Total Knee Arthroplasty: A Noninferiority Randomized Controlled Trial". J Bone Joint Surg Am 97(2015):1129-1141.
Tousignant M, Moffet H, Boissy P, Corriveau H, Cabana F, Marquis F. "A randomized controlled trial of home telerehabilitation for post-knee arthroplasty". J Telemed Telecare 17(2011):195-198.
Russell TG, Buttrum P, Wootton R, Jull GA. "Rehabilitation after total knee replacement via low-bandwidth telemedicine: the patient and therapist experience". J Telemed Telecare 10(2004):85-87.
Dias Correia F, Nogueira A, Magalhaes I, et al. "Home-Based Rehabilitation With a Novel Digital Biofeedback System versus Conventional In-Person Rehabilitation After Total Knee Replacement: A Feasibility Study". Sci Rep 8(2018):11299.
Piqueras M, Marco E, Coll M, et al. "Effectiveness of an interactive virtual telerehabilitation system in patients after total knee arthroplasty: a randomized controlled trial". J Rehabil Med 45(2013):392-396.
Cabana F, Boissy P, Tousignant M, Moffet H, Corriveau H, Dumais R. "Interrater agreement between telerehabilitation and face-to-face clinical outcome measurements for total knee arthroplasty". Telemed J E Health 16(2010):293-298.
Peretti A, Amenta F, Tayebati SK, Nittari G, Mahdi SS. "Telerehabilitation: Review of the State-of-the-Art and Areas of Application". JMIR Rehabil Assist Technol 4(2017):e7.
Lee AC. "COVID-19 and the Advancement of Digital Physical Therapist Practice and Telehealth". Phys Ther 100(2020):1054-1057.
Cranen K, Groothuis-Oudshoorn CG, Vollenbroek-Hutten MM, Ijzerman MJ. "Toward Patient-Centered Telerehabilitation Design: Understanding Chronic Pain Patients' Preferences for Web-Based Exercise Telerehabilitation Using a Discrete Choice Experiment". J Med Internet Res 19(2017):e26.
Nelson M, Bourke M, Crossley K, Russell T. "Telerehabilitation is non-inferior to usual care following total hip replacement - a randomized controlled non-inferiority trial". Physiotherapy 107(2020):19-27.
Nelson M, Russell T, Crossley K, Bourke M, McPhail S. "Cost-effectiveness of telerehabilitation versus traditional care after total hip replacement: a trial-based economic evaluation". J Telemed Telecare 27(2021):359-368.
Eichler S, Salzwedel A, Rabe S, et al. "The effectiveness of telerehabilitation as a supplement to rehabilitation in patients after total knee or hip replacement: randomized controlled trial". JMIR Rehabil Assist Technol 6(2019):e14236.
Levy CE, Silverman E, Jia H, Geiss M, Omura D. "Effects of physical therapy delivery via home video telerehabilitation on functional and health-related quality of life outcomes". J Rehabil Res Dev 52(2015):361-370.
Latulippe K, Hamel C, Giroux D. "Social Health Inequalities and eHealth: A Literature Review With Qualitative Synthesis of Theoretical and Empirical Studies". J Med Internet Res 19(2017):e136.
Weinstein RS, Lopez AM, Joseph BA, et al. "Telemedicine, telehealth, and mobile health applications that work: opportunities and barriers". Am J Med 127(2014):183-187.
Kruse CS, Krowski N, Rodriguez B, Tran L, Vela J, Brooks M. "Telehealth and patient satisfaction: a systematic review and narrative analysis". BMJ Open 7(2017):e016242.
Seron P, Oliveros MJ, Gutierrez-Arias R, et al. "Effectiveness of Telerehabilitation in Physical Therapy: A Rapid Overview". Phys Ther 101(2021):pzab053.
Turolla A, Rossettini G, Viceconti A, Palese A, Geri T. "Musculoskeletal Physical Therapy During the COVID-19 Pandemic: Is Telerehabilitation the Answer?". Phys Ther 100(2020):1260-1264.
Malliaras P, Merolli M, Williams CM, Caneiro JP, Haines T, Barton C. "'It's not hands-on therapy, so it's very limited': telehealth use and views among allied health clinicians during the coronavirus pandemic". Musculoskelet Sci Pract 52(2021):102340.
Fisk M, Livingstone A, Pit SW. "Telehealth in the Context of COVID-19: Changing Perspectives in Australia, the United Kingdom, and the United States". J Med Internet Res 22(2020):e19264.
Bashshur RL, Howell JD, Krupinski EA, Harms KM, Bashshur N, Doarn CR. "The Empirical Foundations of Telemedicine Interventions in Primary Care". Telemed J E Health 22(2016):342-375.
Hoffman DA. "Increasing access to care: telehealth during COVID-19". J Law Biosci 7(2020):lsaa043.
Ramsetty A, Adams C. "Impact of the digital divide in the age of COVID-19". J Am Med Inform Assoc 27(2020):1147-1148.
Nouri S, Khoong EC, Lyles CR, Karliner L. "Addressing Equity in Telemedicine for Chronic Disease Management During the Covid-19 Pandemic". NEJM Catalyst 1(2020).
Eberly LA, Kallan MJ, Julien HM, et al. "Patient Characteristics Associated With Telemedicine Access for Primary and Specialty Ambulatory Care During the COVID-19 Pandemic". JAMA Netw Open 3(2020):e2031640.
Wosik J, Fudim M, Cameron B, et al. "Telehealth transformation: COVID-19 and the rise of virtual care". J Am Med Inform Assoc 27(2020):957-962.
Snoswell CL, Taylor ML, Comans TA, Smith AC, Gray LC, Caffery LJ. "Determining if Telehealth Can Reduce Health System Costs: Scoping Review". J Med Internet Res 22(2020):e17298.
