Telerehabilitation

Telerehabilitation Effectiveness & What A Patient Really Really Wants

CF 217: Telerehabilitation Effectiveness & What A Patient Really Really Wants Today we’re going to talk about the effectiveness of telerehab and we’ll cover what a patient really really wants. This might be a good one to listen to! But first, here’s that sweet sweet bumper music

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Chiropractic evidence-based products

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OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around.  We’re the fun kind of research. Not the stuffy, high-brow kind of research. We’re research talk over a couple of beers. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.   If you haven’t yet I have a few things you should do. 

  • Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s a great resource for patient education and for YOU. It saves you time in putting talks together or just staying current on research. It’s categorized into sections and written in a way that is easy to understand for you and patients. Just search for it on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. 
  • Then go Like our Facebook page, 
  • Join our private Facebook group, and then 
  • Review our podcast on whatever platform you’re listening to 
  • Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com

You have found yourself smack dab in the middle of Episode #216 Now if you missed last week’s episode , we talked about Return To Play After Herniation & Water vs. PT Exercises. Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

If you’ve noticed some inconsistency with the postings of the newest episodes, I’m on it. I’ve got it fixed. We’ll get back to regular Thursday mornings. My podcast server went through an update and it’s taken me a minute to get my feet back under me. But we should be good now.  Alright, how’s everyone been doing? I’m still a little slow from omicron and deductibles re-setting so it is what it is. 

I’m just getting prepared for a presentation I’m doing for the Teas Chiropractic Association’s Mid Winter conference being held in Lubbock, TX on the weekend of February 18th. I’ll be down there with Dr. Tim Bertlesman of ChiroUp fame. He’s one of those guys you’re proud to know and call a friend.  Tim is the one that got me into the whole Neuromusculoskeletal Diplomate thing. He’s a hell of a teacher and a heck of a guy. If you don’t know about ChiroUp or Dr. Tim Bertlesman, fix that now. He’s pretty amazing. 

Beyond that, I’m already gearing up for my trip to St. Augustine, FL for the second MCM Mastermind meeting. That is on the weekend of April 22. I’ll have a trip to Dallas for TCA’s ChiroTexpo in June, another trip in July to Sarasota FL for the Mastermind, then October for the Forensics Diplomate and then November to the Keys for the Mastermind.

My dance card is full, people.  In case you haven’t heard the previous episodes, That Mastermind group is facilitated by Dr. Kevin Christie; another guy that makes you proud to be a chiropractor. We get together and solve each others’ biggest problems and we learn a lot from the presenter and from each other in the meantime. The first meeting was excellent. Go back an episode or two and listen to the episode I did about it. 

Still hiring for the front desk around here. We’re not settling this time. We’re waiting until the rock star walks in. Still looking at potentially hiring an associate. If you’re a rock star and Amarillo, TX sounds intriguing, send me an email at [email protected]

 

Alright, let’s jump in

 

Item #1 The first one here is called, “Effectiveness of Telerehabilitation in Physical Therapy: A Rapid Overview” by Seron et. al. (Seron P 2021) and published in Physical Therapy on June 1, 2021….ssssizzle, pal. 

Why They Did It

The purpose of this article was to summarize the available evidence from systematic reviews on telerehabilitation in physical therapy.

How They Did It

  • We searched Medline/PubMed, EMBASE, and Cochrane Library databases. In addition, the records in PROSPERO and Epistemonikos and PEDro were consulted. 
  • Systematic reviews of different conditions, populations, and contexts-where the intervention to be evaluated is telerehabilitation by physical therapy-were included. 
  • The outcomes were clinical effectiveness depending on specific condition, functionality, quality of life, satisfaction, adherence, and safety. 
  • Data extraction and risk of bias assessment were carried out by a reviewer with non-independent verification by a second reviewer. 
  • Fifty-three systematic reviews were included, of which 17 were assessed as having low risk of bias.

Wrap It Up

Despite the contradictory results, telerehabilitation in physical therapy could be comparable with in-person rehabilitation or better than no rehabilitation for conditions such as osteoarthritis, low-back pain, hip and knee replacement, and multiple sclerosis and also in the context of cardiac and pulmonary rehabilitation. 

Item #2

Our last one today is called “What does the patient with back pain want? A comparison of patient preferences and physician assumptions” by Smuck et. al. (Matthew Smuck 2022) and published in The Spine Journal in February of 2022 oh em gee es muy caliente! 

Why They Did It Low back pain can be difficult to diagnose, leaving patients frustrated and confused after medical visits. The authors wanted to evaluate the importance of reasons for seeking care in patients with back pain, and to compare this to physicians’ assumptions about these patients’ reasons.

How They Did It

  • Prospective survey study carried out at two academic spine centers.
  • A sum of 419 patients with back pain upon initial presentation to a spine clinic, and 198 physicians; all volunteered to complete a survey.
  • Patients were asked to “rate each of the following with regard to their importance to you”: improvement in level of pain, improvement in ability to perform daily tasks, explanation of what is causing your problem, thorough physical examination, diagnostic testing, medication, physical therapy, surgery. 
  • Physicians were asked to rate each of these “with regard to their importance to your patients.”

What They Found

  • Patients indicated the following items were the most important: 
  • explanation of what is causing your problem
  • improvement in level of pain and 
  • improvement in ability to perform daily tasks
  • Patients attributed the least importance and lowest scores to:
  1. surgery and 
  2. medication 

Comparing the mean values to each item by patient and physician responders revealed statistically significant differences in certain items. Specifically, physicians underestimated the importance of an explanation of what is causing the problem and overvalued diagnostic tests, medications and surgery

Wrap It Up

Patients did not place as much importance on diagnostic tests, medications and surgery as the physicians assumed. Physicians understand that back pain patients want improvement in both pain and function, but they underestimate the importance of an explanation for the pain.

Huh, imagine that….physicians placing too much emphasis and importance on medication and surgery. How weird. If only there were a way to get people out of pain in non-complicated musculoskeletal conditions in a non-surgical and non-pharmacological way. 

Oh well….I guess we’ll just never know. Damnit to hell!! 

Alright, that’s it.

Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week. 

Store Remember the evidence-informed brochures and posters at chiropracticforward.com.   

Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!

Chiropractic evidence-based products

Integrating Chiropractors

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The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health!

Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic!

Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. 

Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward.

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About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger  

Bibliography

Matthew Smuck, K. B., Agnes Martinez-Ith, Geoffrey Sultana, Patricia Zheng, (2022). “What does the patient with back pain want? A comparison of patient preferences and physician assumptions.” Spine 22(2): 207-213.  

Seron P, O. M., Gutierrez-Arias R, Fuentes-Aspe R, Torres-Castro RC, Merino-Osorio C, Nahuelhual P, Inostroza J, Jalil Y, Solano R, Marzuca-Nassr GN, Aguilera-Eguía R, Lavados-Romo P, Soto-Rodríguez FJ, Sabelle C, Villarroel-Silva G, Gomolán P, Huaiquilaf S, Sanchez P, (2021). “Effectiveness of Telerehabilitation in Physical Therapy: A Rapid Overview.” Phys Ther 101(6).