Telehealth Delivery Of Therapeutic Exercise For Musculoskeletal Disorders During A Global Pandemic

Abstract

The COVID-19 pandemic has globally disrupted the delivery of healthcare services, particularly for interventions that traditionally require face-to-face interactions, such as manual techniques and therapeutic exercise. Telehealth provides a potential alternative to in-clinic care. However, it has not been well-studied for delivering therapeutic exercise in patients with musculoskeletal (MSK) disorders and little guidance is available on implementation. PURPOSE: The purpose of this paper was to describe the implementation process of a telehealth program for delivering therapeutic exercise in patients with MSK disorders during a global pandemic. METHODS: A quality project was conducted to implement a telehealth program in an outpatient physical therapy organization in the United States. Various implementation outcomes were assessed, such as adoption, adherence, barriers and facilitators, safety, and satisfaction. Representative cases of patients with MSK disorders were also reviewed to illustrate challenges and solutions when administering a telehealth plan of care including exercises. RESULTS: A telehealth program to deliver therapeutic exercise was successfully implemented for patients with MSK disorders presenting for outpatient physical therapy. Barriers, such as limited exercise equipment, technology difficulties, and fall risk safety, were addressed through creative approaches in the home setting. Adherence was high and no adverse events were reported. At its peak, approximately 900 patient visits per month were conducted via telehealth, representing approximately 7% of the total volume. Review of cases suggested good functional outcomes and high satisfaction. CONCLUSION: This project provided insight about implementing a telehealth program focusing on therapeutic exercise for the management of patients with MSK disorders. The findings of this project indicate that telehealth delivery in a physical therapy plan of care is safe, enhances patient access, and allows for continuity of care, which may result in improved functional outcomes. Research is needed to determine the effectiveness of telehealth and updated regulations are needed to clarify roles of providers who are qualified to deliver therapeutic exercises via telehealth.