Telehealth: Time to go mainstream?
Post-operative rehabilitation programs after total joint replacements, such as to the knee or hip, in patients following discharge from hospital have been shown to significantly improve walking distance and speed, as well as muscle strength. These normal take place under the supervision of an Exercise Physiologist or physiotherapist, in a fully equipped clinic. However, access to high-quality rehabilitation services is not always possible, especially for those who live in rural or remote areas, or have difficulty in organising transport.
One solution to improve access for patients to quality rehabilitation, is telerehabilitation. Telerehabilitation technology is able to deliver rehabilitation programs directly into patients’ homes, removing the barriers of geography and transport, and is equally much more financially friendly.
Home exercise programs delivered digitally and via good quality video content, may also encourage patients to exercise more frequently, potentially addressing strength deficits commonly seen in patients who don’t do their rehabilitation diligently.
Online delivered exercise rehabilitation for knee OA – a new approach?
Previous research investigating online-delivered rehabilitation in postoperative orthopedic conditions has yielded promising results. The majority of research in this area has been focused on the total knee replacement (TKR) population. In a recent study out of Canada, 205 people who had total knee arthroplasty were randomised to either an in-home telerehabilitation group (over an internet-based video conferencing platform performed by a trained physiotherapist) or a face-to-face standard in-home physical therapy regime. Both groups received 16 sessions over a two-month period following hospital discharge and included supervised exercises and instructions on home exercises to be done between sessions. The study found:
- There was no difference between the groups with respect to knee function
- The two groups also had similar results for walk time (distance covered in 6 minutes), stair climb test, range of motion (mean flexion at 4 months was 112°), and strength.
These results are similar to previous research. For example, a study out of the University of Queensland, randomised patients to a conventional rehabilitation group, and a telehealth group, for six-weeks. Participants in the telerehabilitation group achieved outcomes comparable to those of the conventional rehabilitation group regarding range of motion, muscle strength, muscle girth, pain, walking speed, quality of life, and self-reported function. Furthermore, patients receiving the telerehabilitation intervention reported a high level of satisfaction also.
The results of these studies are important, given the increasing frequency of knee replacement surgery, shrinking health-care resources, and increasing expectations of patients for a quicker and optimal recovery. Access to high-quality rehabilitation services is a common issue for those who live in rural centres, and not always possible.
But it’s not always those who live hundreds of kilometres away which telehealth is suitable for. For example, if the distance between the clinic and a patient’s home is more than 30 km (round-trip), delivering rehabilitation online after total knee replacement, is less expensive by 18% to 123%, than providing the same service in home. For example, from HFRC – Perth’s leading orthopaedic rehabilitation centre, if you live beyond Carine, Bibra Lake, or Welshpool, Total Joint Care Online may be a better option for you.
Total Joint Care Online has been designed to assist you to achieve the best outcome from your surgery, wherever you live. We do this by providing quality education, expertise, ongoing support and a rehabilitation program formed from 20 years of clinical research via our easy-to-use Online Platform!
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