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Two articles published this spring in PTJ: Physical Therapy & Rehabilitation Journal add to the growing body of literature supporting the role physical therapists can play in telehealth. In one, researchers concluded that telehealth enabled adults with autism spectrum disorder to better participate in physical activity; in the other, researchers identified patients who experienced substantial clinical benefit from telehealth services for low back pain.

Telehealth Feasibility for Adults With Autism Spectrum Disorder

During the COVID-19 pandemic, researchers studied the feasibility of the Physical Activity Connections via Telehealth, aka PACT, program among adults with autism spectrum disorder. PACT is a 10-week intervention that includes an individualized physical activity program and personalized instruction on participating in the program; oversight from doctor of physical therapy students; and weekly support meetings with a group of their peers — all of which was delivered via telehealth.

After screening, 18 adults with ASD between 18 and 32 years old enrolled in PACT. Using a mixed-methods approach, the authors measured quantitative data, such as attendance rates and data from a wearable fitness tracker, and conducted focus groups to gauge participant experiences and other qualitative information. Weekly telehealth session attendance ranged from 70%-100%, with a mean of 93%. Adherence to wearing the fitness tracker ranged from 20%-100%, with a mean of 82%; 13 of the participants adhered between 90% and 100%. In focus group interviews, participants spoke positively about the importance of a structured program with regularly scheduled meetings and a social component, the individualized aspect of PACT, achieving increased self-efficacy due to meeting their goals, and the convenience of a remote program (particularly during the COVID-19 pandemic).

“Telehealth delivery of physical activity interventions is a viable alternative to in-person programs and may enable autistic adults to overcome barriers to physical activity participation and access,” authors write. (“Implementation of Peer-Assisted Physical Activity Via Telehealth for Adults on the Autism Spectrum: A Mixed Methods Feasibility Study,” PTJ: Physical Therapy & Rehabilitation Journal; all PTJ content is available for free to APTA members) 

Who Benefits the Most From Telerehabilitation for Chronic Low Back Pain?

Authors of this study sought to determine which patients with chronic low back pain would be most likely to respond favorably to PT treatment delivered via telehealth, when considering patient demographics, medical history, therapeutic alliance, and more factors. Researchers were conducting the OPTIMIZE trial, which looks at nonpharmacologic treatments such as physical therapist services for chronic LBP, when the COVID-19 pandemic disrupted in-person treatment.

Patients in the study ranged from 18 to 64 years old and had scored four or higher on the Numeric Pain Rating Scale and 24% or higher on the Oswestry Disability Index. Participants received eight sessions of physical therapy delivered via real-time videoconferencing. In addition to measuring patient progress, authors also measured demographics, medical history, psychosocial factors, and therapeutic alliance.

Researchers defined substantial clinical benefit as a change in LBP-related disability by 50% or more at the end of the intervention. Sixteen percent of the 98 patients achieved substantial clinical benefit. A higher proportion of these patients identified as Hispanic and working part or full time compared with their peers who did not see substantial clinical benefit. “Those experiencing substantial clinical benefit reported lower pain intensity, higher pain self-efficacy, and higher therapeutic alliance with their physical therapist compared to other patients,” authors wrote. (“Examining the Relationship Between Individual Patient Factors and Substantial Clinical Benefit From Telerehabilitation Among Patients With Chronic Low Back Pain,” PTJ: Physical Therapy & Rehabilitation Journal; all PTJ content is available for free to APTA members) 

Offering even more evidence of the benefits of telerehab services, nonprofit Peterson Health Technology Institute earlier in June released the report “Virtual Musculoskeletal Solutions Health Technology Assessment.” The report revealed that virtual health technologies, when guided by a physical therapist, deliver ″clinically meaningful improvements in pain and function″ for patients with musculoskeletal conditions. The larger umbrella of digital health can include everything from remote therapeutic monitoring to telehealth.

In addition, APTA has resources for clinicians who want to learn more about telerehabilitation in practice. The APTA Telehealth Certificate Series offers six courses in the APTA Learning Center that ensures PTs, PTAs, and students are prepared to provide excellent care via telehealth. “Telerehabilitation in Physical Therapist Practice: A Clinical Practice Guideline from the American Physical Therapy Association,” provides cutting-edge clinical guidance to help PTs and PTAs put the approach to its most effective use.

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