Online consultation as an alternative for musculoskeletal therapy during the COVID-19 pandemic?

In the current COVID-19 pandemic, most manual therapists have suspended their professional activities. This situation has created many issues with therapists who lost their income and also clients living with pain who need care.

Physiotherapists from Italy asked the question: is telerehabilitation or online consultation the answer for manual therapy during COVID-19 pandemic? They first look for evidence on the effectiveness of telerehabilitation or providing advice via online consultation. Several systematic reviews have assessed the efficacy of telerehabilitation following surgical reconstructions or upper limb surgeries. The findings show promising outcomes of postsurgical rehabilitation therapy in the reduction in pain and improvements in range of motion, muscle strength, functional activities, and disability. This online therapy can achieve similar or even superior results in comparison with face-to-face usual care.

Telerehabilitation, as a stand-alone intervention or in conjunction with usual care, has been effective for chronic musculoskeletal conditions, such as low back pain, lumbar stenosis, neck pain, osteoarthritis, and fibromyalgia. There is some evidence that telerehabilitation as a substitution of hands-on therapy can reduce pain and improve physical function, daily life activities, and quality of life.

Some studies show good acceptability of telerehabilitation in terms of user experience, adherence, and satisfaction. However, online consultation has limitations. Many conditions require assessment, manual therapy, and most importantly, touch. An online consultation can miss lots of crucial conditions.

In summary, telerehabilitation appears to be a promising and timely model of care that can be adopted as an alternative, or in combination with, hands-on care for clients who seek help with musculoskeletal pain during the COVID-19 pandemic. Therapists may first assess clients with a face to face visit and can offer rehabilitation programs of self-care or stretching via online consultation for subsequent follow-ups.

Reference: Turolla, Andrea, et al. “Musculoskeletal Physical Therapy During the COVID-19 Pandemic: Is Telerehabilitation the Answer?” Physical Therapy (2020).