1
|
Sia LL, Sharma S, Ing JBM, Kumar S, Singh DKA. Physiotherapists' perceptions, readiness, enablers, and barriers to use telerehabilitation: A scoping review. J Back Musculoskelet Rehabil 2024:BMR240009. [PMID: 38905032 DOI: 10.3233/bmr-240009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/23/2024]
Abstract
BACKGROUND The growing use of telerehabilitation within the healthcare community has garnered substantial attention. In congruence with other healthcare fields, examining perceptions, barriers, and facilitators assumed paramount significance in the continuation and fortification of telerehabilitation practices among physiotherapists. OBJECTIVE In this scoping review, we aimed to systematically map the literature on the perceptions of physiotherapists as well as the barriers and enablers of telerehabilitation in their daily practice. METHODS The five-stage methodological framework recommended by Arksey and O'Malley (2005) was used for this scoping review. In the framework, eight databases were searched using key search terms such as "telerehabilitation", "physiotherapists", "readiness", "enablers" and "barriers" All findings were organised into perceptions and readiness, enablers, and barriers. RESULTS Fourteen articles met the inclusion criteria and were categorized as: (1) perception and readiness, (2) enablers, and (3) barriers. In the perception and readiness category, new trends in healthcare, advancement in physiotherapy practices and the benefits to clients were identified. The enablers identified included prior training, personal experience, familiarity with technology, functional equipment and space, and client selection. The barriers to the adoption of telerehabilitation in physiotherapy practice are pinpointed to poor technology, communication hurdles, limited availability, lack of familiarity, and client-related concerns. CONCLUSION While initial evidence suggests a generally positive perceptions it is important to consider both facilitators and barriers when understanding adoption. This review's findings revealed a wide research gap, with unequal weightage towards barriers compared to enablers, and highlights the need for further research. Developing telerehabilitation guidelines that cater to both physiotherapists and clients is necessary.
Collapse
Affiliation(s)
- Lee Lee Sia
- Physiotherapy Program and Centre of Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Miri Hospital, Ministry of Health Malaysia, Miri Sarawak, Malaysia
| | - Shobha Sharma
- Speech Sciences Program and Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Janet Bong May Ing
- Physiotherapy Program and Centre of Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Sarawak General Hospital, Ministry of Health Malaysia, Jalan Hospital, Kuching Sarawak, Malaysia
| | - Saravana Kumar
- Allied Health and Human Performance, Level 8, Centenary Building, City East Campus, University of South Australia, Adelaide, SA, Australia
| | - Devinder Kaur Ajit Singh
- Physiotherapy Program and Centre of Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| |
Collapse
|
2
|
Erturan S, Burak M, Elbasan B. Breaking barriers: exploring physiotherapists' willingness and challenges in embracing telerehabilitation in a developing country. Ir J Med Sci 2024; 193:1359-1367. [PMID: 38148393 DOI: 10.1007/s11845-023-03589-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 12/05/2023] [Indexed: 12/28/2023]
Abstract
INTRODUCTION Telerehabilitation (TR) is an innovative approach that can address the limited availability and restricted access to rehabilitation services, particularly during challenging times such as pandemics and natural disasters. This study focuses on understanding the desires, perceptions, and barriers that physiotherapists face when implementing TR in a developing country. METHOD The study was conducted with 219 physiotherapists residing in a developing country using a web-based survey on Google Docs. RESULT The findings revealed that a significant majority of physiotherapists (88.1%) recognized TR as a potential solution for individuals with physical problems during the pandemic. Additionally, 89.5% expressed satisfaction with the opportunity to receive consultations from different hospitals, indicating a positive perception of TR. However, the study also highlighted certain barriers that hindered the implementation of TR. Around 40.2% of physiotherapists reported having training deficiencies, suggesting a need for educational support in utilizing TR effectively. Furthermore, the analysis of demographic factors revealed interesting insights. It was noteworthy that the age and years of experience of physiotherapists had an impact on their willingness and adoption of TR. CONCLUSION The study reveals that physiotherapists in the developing country exhibit a positive attitude towards TR and recognize its potential benefits. However, various barriers, such as training deficiencies, need to be addressed to facilitate a broader adoption of TR in their practices. Overcoming these barriers is anticipated to heighten physiotherapists' readiness to embrace TR, ultimately enhancing the accessibility and delivery of rehabilitation services.
Collapse
Affiliation(s)
- Sinem Erturan
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Ataturk University, Erzurum, Turkey.
| | - Mustafa Burak
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Firat University, Elazığ, Turkey
| | - Bülent Elbasan
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| |
Collapse
|
3
|
Rony RJ, Amir S, Ahmed N, Atiba S, Verdezoto N, Sparkes V, Stawarz K. Understanding the Sociocultural Challenges and Opportunities for Affordable Wearables to Support Poststroke Upper-Limb Rehabilitation: Qualitative Study. JMIR Rehabil Assist Technol 2024; 11:e54699. [PMID: 38807327 DOI: 10.2196/54699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 03/12/2024] [Accepted: 03/18/2024] [Indexed: 05/30/2024] Open
Abstract
Background People who survive a stroke in many cases require upper-limb rehabilitation (ULR), which plays a vital role in stroke recovery practices. However, rehabilitation services in the Global South are often not affordable or easily accessible. For example, in Bangladesh, the access to and use of rehabilitation services is limited and influenced by cultural factors and patients' everyday lives. In addition, while wearable devices have been used to enhance ULR exercises to support self-directed home-based rehabilitation, this has primarily been applied in developed regions and is not common in many Global South countries due to potential costs and limited access to technology. Objective Our goal was to better understand physiotherapists', patients', and caregivers' experiences of rehabilitation in Bangladesh, existing rehabilitation practices, and how they differ from the rehabilitation approach in the United Kingdom. Understanding these differences and experiences would help to identify opportunities and requirements for developing affordable wearable devices that could support ULR in home settings. Methods We conducted an exploratory study with 14 participants representing key stakeholder groups. We interviewed physiotherapists and patients in Bangladesh to understand their approaches, rehabilitation experiences and challenges, and technology use in this context. We also interviewed UK physiotherapists to explore the similarities and differences between the 2 countries and identify specific contextual and design requirements for low-cost wearables for ULR. Overall, we remotely interviewed 8 physiotherapists (4 in the United Kingdom, 4 in Bangladesh), 3 ULR patients in Bangladesh, and 3 caregivers in Bangladesh. Participants were recruited through formal communications and personal contacts. Each interview was conducted via videoconference, except for 2 interviews, and audio was recorded with consent. A total of 10 hours of discussions were transcribed. The results were analyzed using thematic analysis. Results We identified several sociocultural factors that affect ULR and should be taken into account when developing technologies for the home: the important role of family, who may influence the treatment based on social and cultural perceptions; the impact of gender norms and their influence on attitudes toward rehabilitation and physiotherapists; and differences in approach to rehabilitation between the United Kingdom and Bangladesh, with Bangladeshi physiotherapists focusing on individual movements that are necessary to build strength in the affected parts and their British counterparts favoring a more holistic approach. We propose practical considerations and design recommendations for developing ULR devices for low-resource settings. Conclusions Our work shows that while it is possible to build a low-cost wearable device, the difficulty lies in addressing sociotechnical challenges. When developing new health technologies, it is imperative to not only understand how well they could fit into patients', caregivers', and physiotherapists' everyday lives, but also how they may influence any potential tensions concerning culture, religion, and the characteristics of the local health care system.
Collapse
Affiliation(s)
- Rahat Jahangir Rony
- School of Computer Science and Informatics, Cardiff University, Cardiff, United Kingdom
| | - Shajnush Amir
- Faculty of Electrical Engineering, Mathematics & Computer Science, University of Twente, Enschede, Netherlands
| | - Nova Ahmed
- Department of Electrical and Computer Engineering, North South University, Dhaka, Bangladesh
| | | | - Nervo Verdezoto
- School of Computer Science and Informatics, Cardiff University, Cardiff, United Kingdom
| | - Valerie Sparkes
- School of Healthcare Sciences, Cardiff University, Cardiff, United Kingdom
| | - Katarzyna Stawarz
- School of Computer Science and Informatics, Cardiff University, Cardiff, United Kingdom
| |
Collapse
|
4
|
Arza-Moncunill E, Agustín RMS, Medina-Mirapeix F. Measuring and describing perceived quality on physiotherapy practice management software. Int J Med Inform 2024; 185:105406. [PMID: 38461652 DOI: 10.1016/j.ijmedinf.2024.105406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 01/30/2024] [Accepted: 03/07/2024] [Indexed: 03/12/2024]
Abstract
INTRODUCTION Despite the growing trend in the use of digital technologies in physiotherapy, the overall adoption and satisfaction of both, practice management software (PMS) and electronic health records in physiotherapy clinics has been low and slow over time. Satisfaction of expectations or perceived quality (PQ) is an abstract construct based on the discrepancy between expectations and perceptions, to measure the satisfaction of physiotherapists on PMS. This study aims to develop and validate an instrument to measure PQ on PMS, and to describe the PQ of the currently available physiotherapy PMS. METHODS Instrument development study with validity and reliability testing. The development of this questionnaire was conducted in 3 phases: identification of attributes to be explored; development of the item pairs and pretesting; pilot study for item reduction, and psychometric testing. The questionnaire was distributed to chartered physiotherapists. A total of 144 participants completed the questionnaire. RESULTS A series of analyses were conducted to assess item reduction, factor structure of the questionnaire and metric properties of multi-item scales. From the initial 43 attributes, the final version of the Quality Questionnaire on Physiotherapy Practice Management Software consisted of 24 items of PQ on PMS, structured in 3 areas (clinical care, administrative activities, and accounting), which included 11, 9, and 4 items grouped into 4, 3, and 2 scales respectively. The questionnaire proved to be reliable and valid. In multitrait scaling analysis, all scores had strong item-scale correlations, excellent item scaling success, and good internal consistency (Cronbach alpha coefficients of >0.7). CONCLUSIONS Our study provides a valuable PQ questionnaire on PMS attributes for clinical care, administrative activities, and accounting. The attributes related to clinical care and control stock supplies showed a worse PQ. This suggests that those functions related to clinical care should be improved to facilitate greater satisfaction with physiotherapy PMS.
Collapse
|
5
|
Lee AC, Deutsch JE, Holdsworth L, Kaplan SL, Kosakowski H, Latz R, McNeary LL, O’Neil J, Ronzio O, Sanders K, Sigmund-Gaines M, Wiley M, Russell T. Telerehabilitation in Physical Therapist Practice: A Clinical Practice Guideline From the American Physical Therapy Association. Phys Ther 2024; 104:pzae045. [PMID: 38513257 PMCID: PMC11140266 DOI: 10.1093/ptj/pzae045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 01/01/2024] [Indexed: 03/23/2024]
Abstract
A clinical practice guideline on telerehabilitation was developed by an American Physical Therapy Association volunteer guideline development group consisting of international physical therapists and physiotherapists, a physician, and a consumer. The guideline was based on systematic reviews of current scientific literature, clinical information, and accepted approaches to telerehabilitation in physical therapist practice. Seven recommendations address the impact of, preparation for, and implementation of telerehabilitation in physical therapist practice. Research recommendations identify current gaps in knowledge. Overall, with shared decision-making between clinicians and patients to inform patients of service delivery options, direct and indirect costs, barriers, and facilitators of telerehabilitation, the evidence supports the use of telerehabilitation by physical therapists for both examination and intervention. The Spanish and Chinese versions of this clinical practice guideline, as well as the French version of the recommendations, are available as supplementary material (Suppl. Materials).
Collapse
Affiliation(s)
- Alan C Lee
- Physical Therapy Department, Mount Saint Mary’s University, Los Angeles, California, USA
| | - Judith E Deutsch
- Rivers Lab, Department of Rehabilitation and Movement Sciences, Program Physical Therapy, Rutgers University, New Brunswick, New Jersey, USA
- Department of Rehabilitation and Movement Sciences, Program Physical Therapy, Graduate School, Rutgers University, New Brunswick, New Jersey, USA
| | - Lesley Holdsworth
- NHS 24, Caledonia House, 140 Fifty Pitches Rd, Cardinals, Glasgow, Scotland, United Kingdom
| | - Sandra L Kaplan
- Department of Rehabilitation and Movement Sciences, Program Physical Therapy, Rutgers University, New Brunswick, New Jersey, USA
| | - Heidi Kosakowski
- World Physiotherapy, Head of Membership and Policy, Unit 17, Empire Square, London, United Kingdom
| | - Robert Latz
- Chief Information Office (CIO), Trinity Rehabilitation Services, Florence, Kentucky, USA
| | - Lydia Lennox McNeary
- School of Medicine, Virginia Tech Carilion Research Institute, Roanoke, Virginia, USA
| | - Jennifer O’Neil
- Physiotherapy Program, School of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Oscar Ronzio
- Member of World Physiotherapy, Argentine Association of Kinesiology, Buenos Aires, Argentina
| | - Kelly Sanders
- Movement for Life Physical Therapy, Atascadero, California, USA
| | | | - Michele Wiley
- Department of Physical Therapy, Shenandoah University, Winchester, Virginia, USA
| | - Trevor Russell
- RECOVER Injury Research Centre, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia
| |
Collapse
|
6
|
Davies L, Lawford BJ, Chan C. Physiotherapy students' attitudes toward the use of telehealth in clinical practice: A cross-sectional survey. Health Sci Rep 2024; 7:e2067. [PMID: 38650730 PMCID: PMC11033328 DOI: 10.1002/hsr2.2067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 04/09/2024] [Accepted: 04/10/2024] [Indexed: 04/25/2024] Open
Abstract
Background and Aims Provision of physiotherapy services using telehealth has drastically increased since the COVID-19 pandemic and continues to be utilized in clinical practice suggesting telehealth in physiotherapy will become common practice. Prior research has explored the attitudes of physiotherapists with many years of in-person clinical experience toward telehealth. However, little is known about the emerging workforce's attitudes. This study aims to explore physiotherapy students' attitudes toward the use of telehealth in clinical practice. Methods A cross-sectional online survey of physiotherapy students enrolled in the Doctor of Physiotherapy program at Macquarie University between November 2022 and February 2023. Participants rated their level of agreement across 11 statements regarding telehealth use in physiotherapy clinical practice using a 5-point Likert scale ranging from "strongly disagree" to "strongly agree." Participants answered two open-ended questions regarding when they might use telehealth in clinical practice as a physiotherapist and why they believe physiotherapists might be reluctant to use telehealth in clinical practice. Results A total of 118 participants completed the survey (response rate 53%). Overall, most participants believed telehealth would continue being offered post-Covid-19 (86%, n = 101), participants would use some form of telehealth in clinical practice (82%, n 96), believe a blended approach would be beneficial for patients (84%, n = 99), and were interested in further training in telehealth (90%, n = 107). We identified six broad themes, including accessibility, subsequent consultations, inability to provide manual therapies, limited training/education, perceived ineffectiveness, and digital literacy of the patient. Conclusion Overall physiotherapy students believe telehealth will continue being offered in clinical practice, form part of contemporary physiotherapy practice, and are interested in further training to upskill in the delivery of care via telehealth. Given the continued use and students' demand for future training, it may be time to reimagine the inclusion of telehealth education and training in the entry-level physiotherapy curriculum.
Collapse
Affiliation(s)
- Luke Davies
- School of Primary and Allied Health CareMonash UniversityVictoriaAustralia
- Department of Health SciencesMacquarie UniversitySydneyAustralia
| | - Belinda J. Lawford
- Centre for Health, Exercise & Sports MedicineThe University of MelbourneMelbourneAustralia
| | - Cliffton Chan
- Department of Health SciencesMacquarie UniversitySydneyAustralia
| |
Collapse
|
7
|
Fan I, Govil D, King MG, Scholes MJ, Semciw AI. How effective are exercises delivered digitally (requiring internet), amongst patients with hip or knee osteoarthritis? A systematic review and meta-analysis. Osteoarthritis Cartilage 2024; 32:254-265. [PMID: 38030118 DOI: 10.1016/j.joca.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 11/09/2023] [Accepted: 11/13/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVE The aim of this systematic review and meta-analysis is to describe the effect of digitally delivered exercise on pain, physical function and quality of life (QoL) for people with knee or hip osteoarthritis (OA). METHODS Articles were eligible for inclusion if they were of a randomized control trial that evaluated the prescription of digitally delivered exercise (requiring the internet) in people with symptomatic primary hip and/or knee OA. Risk of bias was assessed using the Physiotherapy Evidence Database scale, and levels of evidence were assessed according to Grading of Recommendations Assessment, Development and Evaluation. RESULTS Digitally delivered exercise was delivered via synchronous and asynchronous methods (or a combination of both). Digitally delivered exercise was superior to education only for pain and physical function, with high-quality evidence for quality-of-life outcomes in the long-term (standardized mean difference -0.35, 95% confidence interval -0.59 to -0.12, P = 0.003) in people with knee OA. Furthermore, there was very low to low-quality evidence that digitally delivered exercise was comparable to face-to-face delivery in the short and long-term for people with hip or knee OA and comparable in the medium-term for people with knee OA only. DISCUSSION The review demonstrated very low to low-quality evidence that digitally delivered exercise was comparable to face-to-face delivery for pain, function and QoL. In the absence of higher-level evidence, we would provisionally recommend that healthcare providers offer the choice of face-to-face or digitally delivered exercise intervention for people with hip or knee OA. Further work is required to understand these programs' reach, access, uptake and implementation across diverse population groups.
Collapse
Affiliation(s)
- Iryoung Fan
- Allied Health, Northern Health, Epping, Victoria, Australia; Discipline of Physiotherapy, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia.
| | - Dhruv Govil
- Bass Coast Health, Wonthaggi, Victoria, Australia.
| | - Matthew G King
- Discipline of Physiotherapy, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia; Australian IOC Research Centre, La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia.
| | - Mark J Scholes
- Discipline of Physiotherapy, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia; Australian IOC Research Centre, La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia.
| | - Adam I Semciw
- Allied Health, Northern Health, Epping, Victoria, Australia; Discipline of Physiotherapy, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia.
| |
Collapse
|
8
|
Merolli M, Ahmed O, McCreesh K, Remedios L, Butler-Henderson K. Are physiotherapists expected to be competent in digital health practice? Meta-synthesis of international physiotherapy practice competency standards. Physiother Theory Pract 2024:1-12. [PMID: 38214509 DOI: 10.1080/09593985.2023.2299202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 12/21/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND Digital health technology is progressively transforming physiotherapy practice. Despite a maturing body of literature relating to physiotherapy digital health capability, research examining digital health physiotherapy competency standards is both lacking and lagging. OBJECTIVE Examine international professional practice competency standards for physiotherapists to identify themes common to digital health practice competency, published by international peak organizations governing physiotherapy practice. METHODS Systematic meta-synthesis of international peak organization physiotherapy practice competency standards. The study was undertaken over nine stages. Competency statements related to digital health were extracted, and further coded into resultant themes. RESULTS Eleven documents were analyzed. Fifty-two statements explicitly referenced digital health competency. Identified themes were as follows: 1) digital health data governance; 2) digital health data translation; and 3) digital health technologies. Where digital health-related competency statements do exist, they are skewed toward health information management activities. CONCLUSIONS Digital health practice is currently under-represented in competency standards for physiotherapists. Workforce advancement in light of the burgeoning impact of digital health will prompt further updates to professional competency standards set by our peak organizations. This will have a flow on effect, whereby education providers (e.g. universities and other professional development providers) should consider curriculum and training that prepares individuals for digitally enabled practice.
Collapse
Affiliation(s)
- Mark Merolli
- Centre for Health Exercise, and Sports Medicine, Department of Physiotherapy, School of Health Sciences, University of Melbourne, Parkville, Australia
- Centre for Digital Transformation of Health, University of Melbourne, Carlton, Australia
| | - Osman Ahmed
- Department of Physiotherapy, University Hospitals Dorset NHS Foundation Trust, Poole, UK
- School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Karen McCreesh
- School of Allied Health, University of Limerick, Limerick, Ireland
- Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Louisa Remedios
- Department of Physiotherapy, School of Health Sciences, University of Melbourne, Parkville, Australia
- Institute of Health and Wellbeing, Federation University, Parkville, Australia
| | | |
Collapse
|
9
|
Lange E, Danielsson L. Reaching for connection: a qualitative study of communication and interaction in video-based physiotherapy. Physiother Theory Pract 2023:1-12. [PMID: 38145499 DOI: 10.1080/09593985.2023.2296574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 12/09/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVE Digital technology has become increasingly relevant in physiotherapy, but little is known about communication and interaction in video-based physiotherapy. Therefore, this study aimed to explore the experiences among patients and physiotherapists, of communication and interaction in digital, video-based physiotherapy. METHODS A qualitative interview study with a phenomenological approach was conducted. Participants were purposively recruited from primary health care clinics. Semi-structured, in-depth interviews were conducted with 10 physiotherapists and 6 patients. Interviews were recorded, transcribed, and analyzed using a phenomenological approach. RESULTS The analysis resulted in the overall theme Reaching for connection, which captured the central meaning of the participants' experiences. Four categories emerged from the analysis: 1) Closeness at a distance; 2) Overcoming limited bodily communication; 3) The technology as part of the meeting; and 4) Challenging the physical meeting as a norm. The results suggest that communication and interaction in digital settings differ from physical settings, but there is an ongoing adaptation process to this new paradigm. CONCLUSIONS The results of this study show that video-based physiotherapy, while having several benefits according to both patients and physiotherapists, affects the communication in several ways. Physiotherapists need to acknowledge these limitations and seek strategies to adapt and to compensate for the reduced non-verbal elements and lack of touch. Attention to the physical room and shifting between positions (face/full figure) are suggested practical strategies, but also to practice awareness and embodied communication to improve receptivity in the interaction.
Collapse
Affiliation(s)
- Elvira Lange
- Department of General Practice, Institute of Medicine at the Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
- Research, Education, Development and Innovation, Primary Health Care, Region Västra Götaland, FoUUI-centrum Göteborg och Södra Bohuslän, Göteborg, Sweden
| | - Louise Danielsson
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| |
Collapse
|
10
|
Arza-Moncunill E, Medina-Mirapeix F, Martín-San Agustín R. Development and validity of the expectations of physiotherapists questionnaire on practice management software. PeerJ 2023; 11:e16246. [PMID: 37868065 PMCID: PMC10588714 DOI: 10.7717/peerj.16246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 09/14/2023] [Indexed: 10/24/2023] Open
Abstract
Background Despite the growing trend in the use of digital technologies in physiotherapy, the overall adoption of both, practice management software (PMS) and electronic health records in physiotherapy clinics has been low and slow over time. In order to learn what factors determine the adoption of these technologies by physiotherapists, there is a need to examine the expectations of physiotherapists (EPs) on specific software attributes. The main aims of this study were to develop a questionnaire to measure and describe the EPs towards PMS. The knowledge of these EPs will be useful to guide PMS design in order to improve physiotherapists' satisfaction. Methods Instrument development study with validity and reliability testing. The development of this questionnaire was conducted in three phases: identification of attributes to be explored, development of the items, pilot study, and psychometric testing. The questionnaire was distributed to chartered physiotherapists. A total of 272 participants completed the questionnaire. Results A series of analysis were conducted to assess item reduction, factor structure of the questionnaire and metric properties of multi-item scales. From the initial 43 attributes, the final version of the questionnaire consisted of 26 items on EPs, grouped in nine scales and two areas (clinical care and administrative activities). As a result, all scores had strong item-scale correlations, excellent item scaling success, and good internal consistency (Cronbach alpha coefficients of >.7). Our study also showed that current EPs were high towards most of the items, only two scales concentrated most of the attributes with the least expectations (monitoring quality of care and digital health interventions). Our study included physiotherapists with and without experience with PMS, and it showed that both groups had a similar pattern of expectations. Our study provides a valuable questionnaire of EP on PMS attributes for clinical care and administrative activities and shows a detailed development process.
Collapse
|
11
|
Hawley-Hague H, Gluchowski A, Lasrado R, Martinez E, Akhtar S, Stanmore E, Tyson S. Exploring the delivery of remote physiotherapy during the COVID-19 pandemic: UK wide service evaluation. Physiother Theory Pract 2023:1-15. [PMID: 37610255 DOI: 10.1080/09593985.2023.2247069] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 08/03/2023] [Accepted: 08/06/2023] [Indexed: 08/24/2023]
Abstract
INTRODUCTION During the Coronavirus (Covid-19) pandemic, physiotherapists changed rapidly to working remotely. Research demonstrates the benefits of remote physiotherapy, but little is known about its implementation in practice. PURPOSE Explore the take-up and delivery of remote physiotherapy during the pandemic in the United Kingdom. METHODS Sequential mixed methods evaluation with physiotherapists leading remote physiotherapy delivery. Two-stage approach included online survey (2020) and semi-structured interviews with documentary/data analysis (2021). RESULTS There were 1620 physiotherapists who completed the survey. The most used devices were telephone (n = 942,71.0%) and the AttendAnywhere platform (n = 511, 38.5%). Remote consultations were frequently used for initial assessment (n = 1105, 83%), screening/triage (n = 882, 67%), or to review, monitor, and progress treatment (n = 982-1004, 74%-76%). Qualitative survey responses reflected respondents' response to COVID-19 and delivery of remote physiotherapy. Twelve remote physiotherapy leads were then purposively sampled across clinical areas. Three main themes emerged from interviews: response to Covid-19, delivery of remote physiotherapy, and future of remote physiotherapy. CONCLUSION Remote physiotherapy was safe, feasible, and acceptable for those who accessed it. There were patients for which it was deemed unsuitable across clinical areas. In practice, it should be combined with in-person consultation based on patients' needs/preferences. Further research should explore post-pandemic maintenance of remote delivery.
Collapse
Affiliation(s)
- Helen Hawley-Hague
- School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester and Manchester Academic Health Sciences Centre, Manchester, UK
| | - Ashley Gluchowski
- School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester and Manchester Academic Health Sciences Centre, Manchester, UK
| | - Reena Lasrado
- School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester and Manchester Academic Health Sciences Centre, Manchester, UK
| | - Ellen Martinez
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - Shehnaz Akhtar
- Community Podiatry, Manchester University NHS Foundation Trust, Manchester, UK
| | - Emma Stanmore
- School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester and Manchester Academic Health Sciences Centre, Manchester, UK
| | - Sarah Tyson
- School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester and Manchester Academic Health Sciences Centre, Manchester, UK
| |
Collapse
|
12
|
Roitenberg N, Ben-Ami N. Qualitative exploration of physical therapists' experiences providing telehealth physical therapy during COVID-19. Musculoskelet Sci Pract 2023; 66:102789. [PMID: 37343401 PMCID: PMC10257945 DOI: 10.1016/j.msksp.2023.102789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 05/24/2023] [Accepted: 06/05/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND Physical therapists are trained to provide treatment to patients through a mixture of strategies. The coronavirus (COVID-19) pandemic resulted in social distancing restrictions, and physical therapists, some without previous experience, adopted telehealth physical therapy modalities to treat their patients. OBJECTIVES The objective of this study was to explore physical therapists' experiences of providing telehealth physical therapy during the COVID-19 pandemic. DESIGN AND METHODS A multisite qualitative semi-structured interview study was conducted. Seventeen physical therapists were interviewed by videoconference or by phone, and the interviews were transcribed and analyzed thematically. RESULTS Three main themes emerged from the study. Firstly, physical therapists experienced professional challenges with diagnosing and treating patients hands-off and becoming more verbal. Secondly, telehealth physical therapy was perceived as not feasible or effective for certain patients, attesting to the digital care divide. Lastly, participants' perceptions of patient-therapist communication varied, expressing both communicative advantages and challenges. CONCLUSIONS Physical therapists who practiced telehealth physical therapy during the COVID-19 period experienced information and communication technology as professionally challenging. Physical therapists adapted positively to the use of telehealth physical therapy but perceived that not every patient could benefit from it. The study emphasized the need for a better understanding of physical therapists' hands-off skills for practicing telehealth physical therapy and considers the need to establish a patient classification for telehealth physical therapy.
Collapse
Affiliation(s)
- Neta Roitenberg
- Sociology and Anthropology Department, Bar-Ilan University, Ramat-Gan, Israel.
| | - Noa Ben-Ami
- Physical-Therapy Department, Ariel University, Ariel, Israel
| |
Collapse
|
13
|
Pelckmans M, Nijmolen P, Bloemen M, Kuijpers E, Meershoek A, Rameckers E. Barriers and Facilitators to the Acceptance of eHealth Interventions by Dutch Pediatric Physical Therapists in Times of the COVID-19 Pandemic: A Mixed-Methods Approach. Pediatr Phys Ther 2023; 35:243-250. [PMID: 36722830 PMCID: PMC10035549 DOI: 10.1097/pep.0000000000000998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND The COVID-19 pandemic created an urgent need for eHealth as the relevance of infection control and social distancing continues. Evidence describing the acceptability of implementing eHealth into pediatric physical therapy services is limited. PURPOSE To investigate the determinants of eHealth acceptance by Dutch pediatric physical therapists during the COVID-19 pandemic. METHODS A mixed-methods approach was used. It included a quantitative exploratory questionnaire of 154 pediatric physical therapists and qualitative in-depth interviews of 16 pediatric physical therapists. RESULTS The eHealth interventions were beneficial for collaboration between health care professionals and face-to-face therapy. eHealth interventions were, however, found to be unsuitable especially in the diagnostic phase. Barriers to more extensive application include costs, technical difficulties, and a perceived negative attitude of children. CONCLUSION Pediatric physical therapists used eHealth interventions extensively in times of the COVID-19 pandemic. However, the acceptance of eHealth interventions is dependent on the pediatric physical therapist's perception of usefulness in private practice, rehabilitation setting, or clinical hospital.
Collapse
Affiliation(s)
- Maud Pelckmans
- Correspondence: Maud Pelckmans, MSc, Emmahof 5, 5141DA Waalwijk, the Netherlands ()
| | | | | | | | | | | |
Collapse
|
14
|
O’Neil J, van Ierssel J, King J, Sveistrup H. Telerehabilitation Implementation: Perspectives from Physiotherapists Working in Complex Care. Physiother Can 2023. [DOI: 10.3138/ptc-2022-0072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Purpose: The COVID-19 pandemic resulted in a rapid change in ways clinicians deliver physiotherapy services, leading to an important uprise in telerehabilitation implementation. Sharing the experiences of physiotherapists in clinically adopting this technology during this initial wave of the pandemic can influence future implementation. This mixed-method study aimed to identify the barriers and new facilitators of telerehabilitation clinical implementation. Methods: Canadian physiotherapists with and without telerehabilitation experience, working in various clinical settings, were recruited during the first wave of the COVID-19 pandemic. Participants completed the Assessing Determinants of Prospective Uptake of Virtual Reality instrument (ADOPT-VR) adapted for telerehabilitation and participated in online focus groups to explore their experiences with telerehabilitation implementation. Demographic data and ADOPT-VR responses were analyzed descriptively. Qualitative data were analyzed using content analysis. Results: Sixteen physiotherapists completed the study. Scores on the Likert scale showed that physiotherapists enjoyed telerehabilitation (7.5/10) and perceived it as being useful (7.3/10). Physiotherapists disagreed with the necessity to use only minimal mental efforts (4.4/10) and feeling familiar with the evidence (4.7/10). Limited access to telerehabilitation implementation evidence, a reduced hands-on approach, and a lack of validated remote assessments were reported as barriers. Discussion: Clinical practice guidelines, validated remote neurological assessments, changes in physiotherapy curriculum and policymaking are critical to improving telerehabilitation implementation within physiotherapy practices. Conclusion: Participants positively experienced the quick use of telerehabilitation from the beginning of the COVID-19 pandemic, but some important barriers remain.
Collapse
Affiliation(s)
- Jennifer O’Neil
- From the: University of Ottawa, Faculty of Health Sciences, School of Rehabilitation Sciences, Ottawa, Ontario, Canada
- Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Jacquie van Ierssel
- Children Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Judy King
- From the: University of Ottawa, Faculty of Health Sciences, School of Rehabilitation Sciences, Ottawa, Ontario, Canada
| | - Heidi Sveistrup
- From the: University of Ottawa, Faculty of Health Sciences, School of Rehabilitation Sciences, Ottawa, Ontario, Canada
- Bruyère Research Institute, Ottawa, Ontario, Canada
| |
Collapse
|
15
|
Muacevic A, Adler JR, Lampropoulou S, Xergia S, Bania T, Tsepis E, Billis E. Physiotherapists' Perceptions and Willingness to Use Telerehabilitation in Greece: A Cross-Sectional Study. Cureus 2022; 14:e32317. [PMID: 36628046 PMCID: PMC9825105 DOI: 10.7759/cureus.32317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2022] [Indexed: 12/14/2022] Open
Abstract
Introduction Coronavirus disease 2019 (COVID-19) has affected the healthcare system and the practice of physiotherapists. Telerehabilitation is an alternative method of delivering physiotherapy services. The aim of this study was to investigate physiotherapists' knowledge, beliefs, and willingness to use telerehabilitation in Greece during the COVID-19 pandemic. Materials and methods In this cross-sectional study, Greek physiotherapists completed an online survey between January and February 2022. A questionnaire was distributed via the Panhellenic Physiotherapy Association (PSF). The questionnaire involved 26 items on demographic background, use of technology, overall perceptions, the experience of telerehabilitation, and their opinion on the future of telerehabilitation. The study protocol was approved by the Ethical Committee of the University of Patras, Greece. Results Participants in this study were 213 physiotherapists (female 57.7%; mean age 39.84±8 years). Most physiotherapists (n=118; 55.4%) were working in a private clinic in the areas of outpatient orthopedics, geriatrics, and neurorehabilitation. Overall, most participants (55%) reported increased use of telerehabilitation strategies during the COVID-19 pandemic. A total of 130 physiotherapists (n=61.3%) believed that telerehabilitation may be beneficial as a supplementary way of patient management. Greek physiotherapists made use of low-cost and easily accessible digital technologies, such as mobile phones and online meeting tools (e.g., Skype, Zoom). Although most physiotherapists (79.8%) reported that they wanted to receive more information about digital technology and telerehabilitation, only 42.1% of them did intend to work remotely after the pandemic. Conclusion Most of the participants were willing to deliver physiotherapy via telerehabilitation. Specific education and training programs need to be provided to physiotherapists during and after the pandemic. Healthcare managers should consider the use of telerehabilitation and design guidelines and policies to manage telerehabilitation practices in Greece.
Collapse
|
16
|
Hellstén T, Arokoski J, Sjögren T, Jäppinen AM, Kettunen J. Current state of remote physiotherapy in Finland: cross-sectional web-based questionnaire study. JMIR Rehabil Assist Technol 2022; 9:e35569. [PMID: 35609305 PMCID: PMC9177171 DOI: 10.2196/35569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 05/02/2022] [Accepted: 05/17/2022] [Indexed: 11/13/2022] Open
Abstract
Background The ongoing COVID-19 pandemic has required social, health, and rehabilitation organizations to implement remote physiotherapy (RP) as a part of physiotherapists’ daily practice. RP may improve access to physiotherapy as it delivers physiotherapy services to rehabilitees through information and communications technology. Even if RP has already been introduced in this century, physiotherapists’ opinion, amount of use, and form in daily practice have not been studied extensively. Objective This study aims to investigate physiotherapists’ opinions of the current state of RP in Finland. Methods A quantitative, cross-sectional, web-based questionnaire was sent to working-aged members of the Finnish Association of Physiotherapists (n=5905) in March 2021 and to physiotherapists in a private physiotherapy organization (n=620) in May 2021. The questionnaire included questions on the suitability of RP in different diseases and the current state and implementation of RP in work among physiotherapists. Results Of the 6525 physiotherapists, a total of 9.9% (n=662; n=504, 76.1% female; mean age 46.1, SD 12 years) answered the questionnaire. The mean suitability “score” (0=not suitable at all to 10=fully suitable) of RP in different disease groups varied from 3.3 (neurological diseases) to 6.1 (lung diseases). Between early 2020 (ie, just before the COVID-19 pandemic) and spring 2021, the proportion of physiotherapists who used RP increased from 33.8% (21/62) to 75.4% (46/61; P<.001) in the public sector and from 19.7% (42/213) to 76.6% (163/213; P<.001) in the private sector. However, only 11.7% (32/274) of physiotherapists reported that they spent >20% of their practice time for RP in 2021. The real-time method was the most common RP method in both groups (public sector 46/66, 69.7% vs private sector 157/219, 71.7%; P=.47). The three most commonly used technical equipments were computers/tablets (229/290, 79%), smartphones (149/290, 51.4%), and phones (voice call 51/290, 17.6%). The proportion of physiotherapists who used computers/tablets in RP was higher in the private sector than in the public sector (183/221, 82.8% vs 46/68, 67.6%; P=.01). In contrast, a higher proportion of physiotherapists in the public sector than in the private sector used phones (18/68, 26.5% vs 33/221, 14.9%; P=.04). Conclusions During the COVID-19 pandemic, physiotherapists increased their use of RP in their everyday practice, although practice time in RP was still low. When planning RP for rehabilitees, it should be considered that the suitability of RP in different diseases seems to vary in the opinion of physiotherapists. Furthermore, our results brought up important new information for developing social, health, and rehabilitation education for information and communications technologies.
Collapse
Affiliation(s)
- Thomas Hellstén
- Doctoral Programme in Clinical Research, University of Helsinki, Faculty of Medicine, P.O. Box 63Haartmaninkatu 8, Helsinki, FI.,School of Engineering, Culture and Wellbeing, Arcada University of Applied Sciences, Helsinki, FI
| | - Jari Arokoski
- Department of Physical and Rehabilitation Medicine, Helsinki University Hospital, Helsinki, FI.,Doctoral Programme in Clinical Research, University of Helsinki, Faculty of Medicine, P.O. Box 63Haartmaninkatu 8, Helsinki, FI
| | - Tuulikki Sjögren
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, FI
| | - Anna-Maija Jäppinen
- Department of Internal Medicine and Rehabilitation, Helsinki University Hospital, Helsinki, FI.,University of Helsinki, Helsinki, FI
| | - Jyrki Kettunen
- Graduate School and Research, Arcada University of Applied Sciences, Helsinki, FI
| |
Collapse
|
17
|
Moore C, Wong AYL, de Luca K, De Carvalho D, Johansson MS, Pohlman KA, Miller A, Funabashi M, Dougherty P, French S, Adams J, Kawchuk G. The impact and public health response of chiropractors to the COVID-19 pandemic: a survey across four continents. Chiropr Man Therap 2022; 30:24. [PMID: 35534844 PMCID: PMC9081962 DOI: 10.1186/s12998-022-00432-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 04/15/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The unprecedented impact of COVID-19 on healthcare professionals has implications for healthcare delivery, including the public health guidance provided to patients. This study aims to assess the response and impact of COVID-19 on chiropractors internationally, and examines the public health response of chiropractors to the COVID-19 pandemic practising under a musculoskeletal spine-care versus subluxation-based care paradigm. METHODS A survey was distributed to chiropractors in Australia, Canada, Denmark, Hong Kong, United Kingdom and United States (Oct. 2nd-Dec. 22nd, 2020) via professional bodies/publications, and social media. Questions were categorised into three domains: socio-demographic, public health response and business/financial impact. Multivariable logistic regression explored survey items associated with chiropractors practising under different self-reported paradigms. RESULTS A total of 2061 chiropractors representing four global regions completed the survey. Our recruitment method did not allow the calculation of an accurate response rate. The vast majority initiated COVID-19 infection control changes within their practice setting, including increased disinfecting of treatment equipment (95%), frequent contact areas (94%) and increased hand hygiene (94%). While findings varied by region, most chiropractors (85%) indicated that they had implemented regulator advice on the use of personal protective equipment (PPE). Suspension of face-to-face patient care during the peak of the pandemic was reported by 49% of the participants with 26% implementing telehealth since the pandemic began. Chiropractors practising under a musculoskeletal spine-care paradigm were more likely to implement some/all regulator advice on patient PPE use (odds ratio [OR] = 3.25; 95% confidence interval [CI]: 1.57, 6.74) and practitioner PPE use (OR = 2.59; 95% CI 1.32, 5.08); trust COVID-19 public health information provided by government/World Health Organisation/chiropractic bodies (OR = 2.47; 95% CI 1.49, 4.10), and initiate patient telehealth in response to COVID-19 (OR = 1.46; 95% CI 1.02, 2.08) compared to those practising under a subluxation-based paradigm. CONCLUSIONS Chiropractors who responded to our survey made substantial infectious control changes in response to COVID-19. However, there was regional variation in the implementation of the advised practitioner and patient use of PPE and limited overall use of telehealth consultations by chiropractors during COVID-19. Musculoskeletal spine-care chiropractors were more adaptive to certain COVID-19 public health changes within their practice setting than subluxation-based chiropractors.
Collapse
Affiliation(s)
- Craig Moore
- Department of Chiropractic, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Arnold Y. L. Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Katie de Luca
- Department of Chiropractic, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | | | - Melker S. Johansson
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Department of Public Health, University of Southern Denmark, Odense, Denmark
| | | | - Amy Miller
- AECC University College, Bournemouth, UK
| | - Martha Funabashi
- Division of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Canada
- Department of Chiropractic, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | | | - Simon French
- Department of Chiropractic, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Jon Adams
- School of Public Health, Faculty of Health, University of Technology, Sydney, Australia
| | - Greg Kawchuk
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| |
Collapse
|
18
|
Keel S, Schmid A, Keller F, Schoeb V. Investigating the use of digital health tools in physiotherapy: facilitators and barriers. Physiother Theory Pract 2022:1-20. [PMID: 35293846 DOI: 10.1080/09593985.2022.2042439] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Digital tools are becoming more and more common in healthcare. Their potential to improve treatment, monitoring, and coaching in physiotherapy has been recognized. Yet studies report that the adoption of digital health tools in ambulatory physiotherapy is rather low and that their potential is underexploited. OBJECTIVE This paper aims to investigate how digital health tools in general, and the mobile health tool physitrackTM (hereafter the app) more particularly, are used in outpatient physiotherapy clinics and also to identify what facilitates or hinders the app's use. METHODS The paper is part of a larger study and adopts an ethnographic approach. It is based on observational and interview data collected at two outpatient clinics. RESULTS We reveal how physiotherapists and patients use the app in physiotherapy and identify 16 interdependent factors, on the macro-, meso-, and micro-level, that either facilitate or hinder its use. CONCLUSIONS We argue that a single factor's facilitating or hindering impact cannot be grasped in isolation but needs to be investigated as one piece of a dynamic interplay. Further qualitative research is required, especially to shed more light on the app's compatibility with physiotherapy practice and use in therapist-patient interactions.
Collapse
Affiliation(s)
- Sara Keel
- School of Health Sciences, (HESAV), HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne Switzerland
| | - Anja Schmid
- School of Health Sciences, (HESAV), HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne Switzerland
| | - Fabienne Keller
- School of Health Sciences, (HESAV), HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne Switzerland
| | - Veronika Schoeb
- School of Health Sciences, (HESAV), HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne Switzerland
| |
Collapse
|
19
|
Kelly M, Fullen B, Martin D, McMahon S, McVeigh JG. eHealth Interventions to Support Self-Management in People With Musculoskeletal Disorders, "eHealth: It's TIME"-A Scoping Review. Phys Ther 2022; 102:6506314. [PMID: 35079826 PMCID: PMC8994513 DOI: 10.1093/ptj/pzab307] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 10/27/2021] [Accepted: 11/29/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE eHealth-mediated interventions have been proposed as one option to support self-management in those with musculoskeletal disorders (MSDs). This scoping review aimed to chart the evidence regarding eHealth modalities, musculoskeletal diagnosis, and outcomes of eHealth-mediated self-management support interventions in persons with MSDs and identify any gaps within the literature. METHODS Six electronic databases (MEDLINE, CINAHL, PsycINFO, Embase, Scopus, and the Cochrane Database of Systematic Reviews), 7 grey literature sources (eg, OpenGrey), and reference and citation lists of included studies were searched from database inception to July 2020. Published studies of adult participants with a MSD utilizing an eHealth intervention to support self-management were included. Studies were limited to those published in English. Two reviewers independently screened all studies. Data were extracted by 1 reviewer and reviewed by another reviewer. RESULTS After screening 3377 titles and abstracts followed by 176 full texts, 87 studies fulfilled the eligibility criteria. The majority were published in the last 5 years (n = 48; 55%), with almost one-third originating in the United States (n = 28; 32%). The most common eHealth modality type was internet based (n = 22; 35%), with almost one-half (n = 41; 47%) of the included studies involving participants with widespread musculoskeletal symptoms. The most commonly reported outcomes were related to body functions (ie, pain intensity) (n = 67; 45%), closely followed by activities and participation (ie, function) (n = 65; 44%), with environmental factors (ie, health care utilization) the least commonly reported (n = 17; 20%). CONCLUSIONS There is considerable variation within the eHealth-mediated self-management support intervention literature. Research is needed on the role of eHealth-mediated self-management support interventions across a broad range of MSDs to guide clinical practice. IMPACT This scoping review has identified gaps in the literature relating to specific eHealth modalities, musculoskeletal diagnoses, and health care utilization data, which should guide future research.
Collapse
Affiliation(s)
- Marie Kelly
- Discipline of Physiotherapy, School of Clinical Therapies, College of Medicine and Health, University College Cork, Cork, Ireland,Department of Physiotherapy, Mercy University Hospital, Cork, Ireland,Address all correspondence to Marie Kelly at:
| | - Brona Fullen
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Denis Martin
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom,NIHR Applied Research Collaborative, North East and North Cumbria, United Kingdom
| | - Sinéad McMahon
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Joseph G McVeigh
- Discipline of Physiotherapy, School of Clinical Therapies, College of Medicine and Health, University College Cork, Cork, Ireland
| |
Collapse
|
20
|
Implementation of telerehabilitation in Austrian outpatient physiotherapy – A qualitative study / Implementierung von Telerehabilitation in der ambulanten Physiotherapie in Österreich – Eine qualitative Studie. INTERNATIONAL JOURNAL OF HEALTH PROFESSIONS 2022. [DOI: 10.2478/ijhp-2022-0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Abstract
Background
New technologies, for example, telerehabilitation (TR) tools, can support physiotherapists’ work. Even though studies have demonstrated their potential, TR is not yet fully implemented in Austrian outpatient physiotherapy. As a result of the Coronavirus pandemic and the associated lockdowns, physiotherapists in Austria were confronted with the challenge of offering therapies without physical contact. This study aims to investigate opinions and experiences of physiotherapists in Austria regarding TR and its implementation in different clinical fields.
Methods
A qualitative research design with expert interviews and a focus group discussion were conducted. Data were analysed using content analysis. The categories were formed following a deductive-inductive approach.
Results
The interview partners considered opportunities for using synchronous TR in internal medicine as well as orthopaedics and traumatology, especially in later, exercise-dominated stages. In addition, using TR can be supportive for patient education. In the field of neurology, synchronous TR is viewed with some criticism, especially when used for people with severe neuropsychological disorders. Asynchronous TR is considered useful across all disciplines and could support physical therapy from the first therapy session and throughout the treatment. Important questions regarding liability, billing, or data protection still need to be clarified. Interdisciplinary approaches in TR should also be pursued to improve care.
Conclusion
The use of asynchronous TR in addition to regular physiotherapy is seen as promising in all clinical fields. In general, when implementing TR, the needs and requirements of different fields should be considered. Moreover, various framework conditions still need to be clarified for further implementation of TR.
Collapse
|
21
|
Meireles ALF, Mendes MES, Silveira SD, Machado HDS. Characteristics and perceptions of telerehabilitation consultations by neuropediatric physical therapists during the COVID-19 pandemic. FISIOTERAPIA EM MOVIMENTO 2022. [DOI: 10.1590/fm.2022.35110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Introduction: The COVID-19 pandemic brought a strong discussion about telerehabilitation, especially in countries where its practice was not allowed previous the pandemic. In the neuropediatric rehabilitation field evidence of the effectiveness of this modality of assistance and data about provider and family’s perceptions are scarce. Objective: To evaluate the characteristics of telerehabilitation physical therapy consultations for children with neurological diseases during the COVID-19 pandemic and report the perceptions of physical therapists about this modality of assistance. Methods: An online survey was created and administered to Brazilian neuropediatric physical therapists. The survey consisted of demographics data, questions about the characteristics of telerehabilitation consultations, and physical therapists’ perception of telerehabilitation assistance. Results: From July to September 2020, 394 physical therapists responded to the questionnaire. The most of them took 21 to 30 minutes per telemonitoring session (26.9%), offered one session per week (61.0%), and used electronic messages as the main method of delivery (39.9%). The main difficulty reported was caregivers’ lack of understanding about handling during sessions (41.2%) and problems with internet connection (16.7%). Additionally, most of them reported that it is highly important important to provide healthcare via telerehabilitation to the economically disadvantaged. Conclusion: The findings of this study provide insight into the complex and challenging process of telerehabilitation assistance during the first wave of the COVID-19 pandemic. Despite the reported challenges, telerehabilitation can be an opportunity to better understand children’s activities and participation in home context.
Collapse
|
22
|
Ezema CI, Onyeso OK, Okafor UA, Mabry LM, Adje ME, Shiraku J, Brismée JM, Froment F, Stewart A, Awosoga OA. Knowledge, attitude and adherence to standard precautions among frontline clinical physiotherapists during the COVID-19 pandemic: a cross-sectional survey. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2021. [DOI: 10.1080/21679169.2021.2020898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Charles I. Ezema
- Department of Physiotherapy, Faculty of Health Sciences, Gregory University, Uturu, Nigeria
- Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Nsukka, Nigeria
| | - Ogochukwu K. Onyeso
- Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Nsukka, Nigeria
- Faculty of Health Sciences, University of Lethbridge, Alberta, Canada
| | - Udoka A. Okafor
- Department of Physiotherapy, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Lance M. Mabry
- Department of Physical Therapy, High Point University, High Point, NC, USA
| | - Mishael E. Adje
- Department of Therapeutic Sciences, Trier University of Applied Sciences, Trier, Germany
| | - Jessica Shiraku
- Department of Physical Medicine and Rehabilitation, The Nairobi Hospital, Nairobi, Kenya
| | - Jean-Michel Brismée
- Department of Rehabilitation Sciences, Center for Rehabilitation Research, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Frédéric Froment
- Department of Rehabilitation Sciences, Center for Rehabilitation Research, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Aimee Stewart
- Department of Physiotherapy, School of Therapeutic Sciences, Faculty of Health Sciences University of the Witwatersrand, Johannesburg, South Africa
| | - Olu A. Awosoga
- Faculty of Health Sciences, University of Lethbridge, Alberta, Canada
| |
Collapse
|
23
|
Virtual World Café Method for Identifying Mental Health Research Priorities: Methodological Case Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010291. [PMID: 35010550 PMCID: PMC8744911 DOI: 10.3390/ijerph19010291] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 12/24/2021] [Accepted: 12/25/2021] [Indexed: 12/24/2022]
Abstract
People with lived experience of mental health problems as both consumers and carers can bring significant expertise to the research process. However, the methods used to gather this information and their subsequent results can vary markedly. This paper describes the methods for two virtual World Cafés held to gather data on consumer and carer priorities for mental health research. Several methodological processes and challenges arose during data collection, including the achieved recruitment for each group (n = 4, n = 7) falling significantly short of the target number of 20 participants per group. This led to departures from planned methods (i.e., the use of a single ‘room’, rather than multiple breakout rooms). Despite this, the participants in the virtual World Cafés were able to generate over 200 ideas for research priorities, but not identify agreed-upon priorities. Virtual World Cafés can quickly generate a significant volume of data; however, they may not be as effective at generating consensus.
Collapse
|
24
|
Internationale Rahmenbedingungen für Kernkompetenzen von Physiotherapeut*innen zur Bereitstellung einer qualitativ hochwertigen Versorgung über Videokonferenzen: eine Delphi-Studie. PHYSIOSCIENCE 2021. [DOI: 10.1055/a-1623-6147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
25
|
Bruder-Hofstetter M. Digitalisierung im Gesundheitswesen – wo steht die Physiotherapie heute? PHYSIOSCIENCE 2021. [DOI: 10.1055/a-1623-6016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|