This study evaluated the feasibility of an 8-week physical therapy program for persons with chronic low back pain provided entirely using telehealth with real-time, interactive video sessions with a physical therapist.
At the time of the onset of the COVID pandemic, the research team was conducting a clinical trial (the OPTIMIZE trial) investigating different nonpharmacologic treatments for persons with chronic low back pain (NCT03859713). One intervention arm in this trial is in-person physical therapy. COVID-related restrictions on in-person care prompted suspension of the OPTIMIZE trial. In order to accommodate persons in the midst of receiving treatment at the time of suspension, the study team adapted the in-person protocol for physical therapy for telehealth delivery using two-way, real-time video sessions. Because of the lack of research examining the feasibility of telehealth physical therapy provided in this manner, the study team decided to conduct a pilot study to examine the feasibility of the telehealth protocol. This study was a prospective, longitudinal cohort of persons with chronic LBP seeking care in one of three healthcare systems; University of Utah Health and Intermountain Healthcare in Salt Lake City, Utah, and Johns Hopkins Medicine in Baltimore, Maryland. All participants were offered up to 8 weekly sessions of telehealth physical therapy. Outcomes included measures of acceptability, appropriateness, feasibility and fidelity as well as effectiveness measures including the Oswestry Disability Index and the PROMIS-29 health domains. Assessments occurred at baseline and after 10- and 26-weeks.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
126
Weekly sessions of physical therapy provided using two-way, interactive, video technology consisting of education, advice and exercise instruction.
Johns Hopkins University
Baltimore, Maryland, United States
Intermountain Health Care
Salt Lake City, Utah, United States
Participant Satisfaction with Telehealth Treatment
Survey of participants evaluating treatment satisfaction
Time frame: 10-weeks
Rate of refusal to participate
Ratio of persons entering the study among all those eligibility for enrollment
Time frame: Baseline
Rate of enrolled participants initiating telehealth treatment
Ratio of persons attending at least 1 treatment session among all those enrolled
Time frame: 10-weeks
Number of sessions
Number of telehealth physical therapy sessions attended
Time frame: 10-weeks
Change in Oswestry from baseline to 10-weeks
10 item measure of back pain-related disability
Time frame: baseline, 10 weeks
Change in Oswestry from baseline to 26-weeks
10 item measure of back pain-related disability
Time frame: baseline, 26 weeks
Change in Pain Interference from baseline to 10 weeks
PROMIS 4-item short form (part of PROMIS-29) assessed as a T-score with mean = 50 and SD = 10
Time frame: baseline, 10 weeks
Change in Pain Interference from baseline to 26 weeks
PROMIS 4-item short form (part of PROMIS-29) assessed as a T-score with mean = 50 and SD = 10
Time frame: baseline, 26 weeks
Change in Pain Intensity from baseline to 10 weeks
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PROMIS single item (part of PROMIS-29) assessing pain intensity on 0-10 rating scale
Time frame: baseline, 10 weeks
Change in Pain Intensity from baseline to 26 weeks
PROMIS single item (part of PROMIS-29) assessing pain intensity on 0-10 rating scale
Time frame: baseline, 26 weeks
Change in Fatigue from baseline to 10 weeks
PROMIS 4-item short form (part of PROMIS-29) assessed as a T-score with mean = 50 and SD = 10
Time frame: baseline, 10 weeks
Change in Fatigue from baseline to 26 weeks
PROMIS 4-item short form (part of PROMIS-29) assessed as a T-score with mean = 50 and SD = 10
Time frame: baseline, 26 weeks
Change in Sleep Disturbance from baseline to 10 weeks
PROMIS 4-item short form (part of PROMIS-29) assessed as a T-score with mean = 50 and SD = 10
Time frame: baseline, 10 weeks
Change in Sleep Disturbance from baseline to 26 weeks
PROMIS 4-item short form (part of PROMIS-29) assessed as a T-score with mean = 50 and SD = 10
Time frame: baseline, 26 weeks
Change in Anxiety from baseline to 10 weeks
PROMIS 4-item short form (part of PROMIS-29) assessed as a T-score with mean = 50 and SD = 10
Time frame: baseline, 10 weeks
Change in Anxiety from baseline to 26 weeks
PROMIS 4-item short form (part of PROMIS-29) assessed as a T-score with mean = 50 and SD = 10
Time frame: baseline, 26 weeks
Change in Depression from baseline to 10 weeks
PROMIS 4-item short form (part of PROMIS-29) assessed as a T-score with mean = 50 and SD = 10
Time frame: baseline, 10 weeks
Change in Depression from baseline to 26 weeks
PROMIS 4-item short form (part of PROMIS-29) assessed as a T-score with mean = 50 and SD = 10
Time frame: baseline, 26 weeks
Change in Social Role Participation from baseline to 10 weeks
PROMIS 4-item short form (part of PROMIS-29) assessed as a T-score with mean = 50 and SD = 10
Time frame: baseline, 10 weeks
Change in Social Role Participation from baseline to 26 weeks
PROMIS 4-item short form (part of PROMIS-29) assessed as a T-score with mean = 50 and SD = 10
Time frame: baseline, 26 weeks
Change in Physical Function from baseline to 10 weeks
PROMIS 4-item short form (part of PROMIS-29) assessed as a T-score with mean = 50 and SD = 10
Time frame: baseline, 10 weeks
Change in Physical Function from baseline to 26 weeks
PROMIS 4-item short form (part of PROMIS-29) assessed as a T-score with mean = 50 and SD = 10
Time frame: baseline, 26 weeks
Change in Pain Self-Efficacy Scale from baseline to 10 weeks
10-item measure of confidence in performing activities even with pain
Time frame: baseline, 10 weeks
Change in Pain Self-Efficacy Scale from baseline to 26 weeks
10-item measure of confidence in performing activities even with pain
Time frame: baseline, 26 weeks