Retrospective Case-Control Study on the Effect of In-Person Physical Therapy With Remote Therapeutic Monitoring on Functional Outcomes and Plan of Care Adherence Amongst Individuals With Musculoskeletal Conditions

回顾性病例对照研究:远程治疗监测结合面对面物理治疗对肌肉骨骼疾病患者功能恢复和治疗方案依从性的影响

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Abstract

OBJECTIVE: To evaluate the efficacy of in-person physical therapy (PT) coupled with remote therapeutic monitoring (RTM) compared to in-person PT only on patient outcomes and care delivery. DESIGN: A case-control study. SETTING: 95 private practice physical therapy clinics. RTM is delivered at home via a mobile application. PARTICIPANTS: Inclusion criteria included: (1) Adults ≥18 years of age, (2) musculoskeletal diagnosis, (3) clinician-prescribed PT, (4) at least 2 outcome measures. Patients who met the inclusion criteria were enrolled in RTM. A control group was generated using 3:1 matching based on: age, sex, case type, and intake patient-reported outcome score. Three hundred and six cases for the in-person PT + RTM group (N = 306) and 918 (N = 918) controls were identified. INTERVENTIONS: RTM Patients were enrolled in a home exercise program administered through a mobile application, with digital exercise therapy videos and care navigation support. Both RTM and control patients were enrolled in in-person PT. MAIN OUTCOME MEASURES: Achieving the discharge functional status score as measured by the binary yes/no Functional Status Benchmark. RESULTS: A significantly greater proportion of PT + RTM patients achieved the Functional Statue Benchmark (72%) compared to the control group (63%, P=.004). A statistically greater proportion of PT + RTM patients attended more than 2 visits per week (36%) compared to the control group (24%, P<.001). When controlling all variables, RTM participation was a significant predictor of achieving the discharge functional status score as measured by the binary yes/no Functional Status Benchmark (adjusted odds ratio, 1.53; 95% confidence interval, 1.04-2.22). CONCLUSIONS: The inclusion of RTM with in-person PT facilitated better patient engagement and patient-reported outcomes compared to in-person PT only.

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