Musculoskeletal conditions are very common in Canada and are the leading cause of disability. They result in limited mobility, disrupted work productivity, and reduced participation in society. Yet, in-person physiotherapy for musculoskeletal conditions is not universally accessible, especially for people living in rural and remote regions or with time-intensive occupational or caring responsibilities. Reduced access to in-person physiotherapy services during the COVID-19 pandemic highlighted the importance of alternative delivery models, such as virtual care, to facilitate patients’ timely access to services.
Virtual care broadly refers to ways that health care professionals remotely interact with patients including telehealth and digital practice. Despite an emerging body of research supporting the efficacy of telehealth as being comparable to in-person care for the physiotherapy management of many musculoskeletal conditions, implementation by physiotherapists before the pandemic was very limited. However, since the start of the pandemic, many physiotherapists have adopted telehealth for the first time.
Our pan-Canadian survey launched in May 2020 and published in Physiotherapy Canada, found that 60% of physiotherapists were less confident in managing patients virtually compared to in-person, they expressed a lack of sufficient training, and yet 84% planned to continue with virtual care beyond the pandemic. Responding to this unmet need, we used modified experience-based co-design methods (physiotherapists, clinic administrators, and people with musculoskeletal conditions) to develop a web-based, evidence-informed toolkit for physiotherapists managing musculoskeletal conditions via telehealth. We also conducted a preliminary evaluation of the toolkits’ usability and ability to improve telehealth-related confidence, knowledge, and perceived competence of physiotherapist users. This mixed methods project is currently under review for publication, but in the meantime, lease explore the freely available web-based toolkit. We hope this resource will continue to be updated, expanded, and disseminated widely to support physiotherapists in providing high-quality virtual care for people with musculoskeletal conditions.
The TREK Musculoskeletal Telehealth Toolkit includes:
- Evidence on telehealth in musculoskeletal physiotherapy
- Short video clips demonstrating assessment techniques via telehealth
- Tips and resources for implementing telehealth in clinical settings
- Patient and clinician lived experience telehealth videos
- Patient resources (infographics, video clips) on how to prepare for telehealth, technology tips, and frequently asked questions about telehealth
Dr. Allison Ezzat is a physiotherapist clinician scientist and postdoctoral research fellow at La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Australia, as well as a Clinical Assistant Professor in the Department of Physical Therapy, University of British Columbia. Her research focuses on using implementation science methodology to advance the prevention of knee injuries and improve access to non-surgical care for people with knee osteoarthritis. She is also passionate about leading knowledge translation of research to practice in the physiotherapy community. She has a leadership role with the Good Life with osteoArthritis in Denmark (GLA:D®) Australia program leading numerous implementation projects.
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