P195 Using remote access musculoskeletal consultations within a cystic fibrosis specialist physiotherapy service: a pilot

Abstract

During COVID-19, musculoskeletal (MSK) physiotherapists were redeployed to supplement acute staffing. Virtual clinics (VC) were used by the cystic fibrosis (CF) MDT to assess and monitor patients. Objectives: To scope benefits of providing MSK physiotherapy to allow pwCF to self-manage their condition and improve their quality of life (QOL). Methods: VC for MSK pain were offered for 6 weeks. Patient satisfaction and perceived resolution of symptoms was assessed. Results: 15 patients had an average of 1.5 treatment sessions. MSK problems included peripheral joint pain n = 12;spine n = 2 and TMJ. 91% of pwCF were seen within 3 days of referral with remainder seen within 1 week. 55% responded to a satisfaction survey. 83% of pwCF felt a 58% improvement in symptoms. 50% felt the support received was sufficient with 50% requiring additional follow-up. Future access to CF MSK services was considered favourably. 33% stated a preference for face-to-face consultation, with 50% finding VC to be a ‘convenient alternative’. PwCF have an increased prevalence of spinal deformities such as kyphosis and scoliosis, the same prevalence of MSK pain as age-matched controls and pain in pwCF rising with age and associated co-morbidities. 94% of pwCF may experience pain limiting airway clearance and subsequent QOL. PwCF often describe the negative impact pain has on their ability to stay active and function in daily life. UK national standards of care recommend that ‘all individuals with CF should be screened for MSK signs and symptoms, with referral pathways to access MSK specialists where appropriate’ suggesting that MSK specialist input within CF centres would be ideal. In Glasgow, there is currently no specialist CF MSK physiotherapy provision and local specialist services have a current waiting list of 44 weeks. Conclusion: This study demonstrated that pwCF feel specialist CF MSK input is valuable and significantly reduced their pain within a short period of time, thus maintaining their QOL.