Associations Between Telerehabilitation and Outcomes for Patients with Low Back Pain During the COVID-19 Pandemic

Abstract

<h3>Research Objectives</h3> To examine associations between frequency of telerehabilitation i.e., any few, most or all, and outcomes of functional status, number of visits, and patient satisfaction during COVID-19 and to compare functional status outcomes by telerehabilitation delivery mode i.e., synchronous, asynchronous, mixed, for patients with low back pain. <h3>Design</h3> Retrospective observational cohort. <h3>Setting</h3> Outpatient rehabilitation. <h3>Participants</h3> Sample consisted of 91,117 episodes of care (58% women; mean age = 55 [SD = 18]). <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> Lumbar Computer Adaptive Test (LCAT) patient-reported outcome measure was administered to assess functional status. LCAT has been shown to be reliable, valid, and responsive. Number of visits during the episode of care were documented at discharge. Data on patient satisfaction with treatment results were collected: "How satisfied were you with overall results of your treatment at this facility?" <h3>Results</h3> Telerehabilitation was administered in 5013 care episodes (5.5%). Propensity score matching was used to match episodes of care with or without telerehabilitation exposure by the probability of receiving telerehabilitation. Standardized differences were used to compare samples before and after matching. All standardized differences between matched samples were < 0.1. There was no significant difference in functional status points (range = 0–100, with higher representing better functional status) between matched samples, except for episodes that had few (−1.7) and all (+2.0) telerehabilitation frequencies or that involved the asynchronous (−2.6) telerehabilitation mode. These point differences suggest limited clinical importance. Episodes with any telerehabilitation frequency involved significantly fewer visits (0.7 to 1.3) than episodes with no telerehabilitation, except that those with the most telerehabilitation frequencies had nonsignificantly fewer visits (0.6). A smaller proportion of patients with telerehabilitation than of patients with no telerehabilitation (−4.0% to −5.0%, respectively) reported being very satisfied with treatment results, except for those with the ‘all' telerehabilitation frequency. <h3>Conclusions</h3> A positive association between telerehabilitation and outcomes was observed, with a trend for better functional status outcomes and fewer visits when all care was delivered through telerehabilitation. Satisfaction tended to be lower with telerehabilitation use. <h3>Author(s) Disclosures</h3> No conflicts to declare.