Table 4.
Summary of characteristics of included validity, reliability and utility studies
| First author & year; Area of PT practice | Title | Study design | Relevant analysis used | Participants | Telehealth assessment environment | Telehealth assessment delivery & technology | Quality rating (%) and descriptor |
|---|---|---|---|---|---|---|---|
| Avelino, 2020 [41]; Neurological |
Validation of the telephone-based application of the ABILHAND for assessment of manual ability after stroke. |
Validity study: Cross-sectional design. |
Descriptive, mean difference, Intraclass Correlation Coefficient (ICC), weighted Kappa (κ), 95% confidence interval (CI). |
102 participants (49% male, mean age 65yrs ±13) with stroke (mean time 37 d post ±38) recruited from the community in Brazil. |
Participants completed the ABILHAND assessment F2F and by telephone 5-7 d apart. Further details on location of participant not provided. |
Synchronous telephone telehealth consultation. No further details described. |
67%, Good |
| Boggs, 2020 [42]; Cancer Care |
Telehealth and physical therapy clinical decision making in a patient with a falcine meningioma. |
Utility study: Case report. |
Descriptive. |
A 50-y-old male presenting with 2-d history of left-sided numbness/tingling. |
Further details of the location of participant not provided. |
Synchronous telephone telehealth consultation. |
Case report, N/A |
| Cabana, 2010 [43]; Musculo-skeletal |
Interrater agreement between telerehabilitation and face-to-face clinical outcome measurements for total knee arthroplasty. |
Interrater reliability study. |
Krippendorff’s α reliability estimate, mean difference between methods (%) (95% CI). |
15 participants (8 males, mean age 62 y) recently discharged after total knee arthroplasty surgery. |
Home setting via telehealth (n = 9) or second clinical environment (n = 6). Research assistant was on-site for safety. |
Synchronous VC telehealth consultation. 2x H264 VC Coder Decoders (Tandberg 500 MXP, Canada), integrated wide-angle cameras, 20-inch LCD TVs, modular software interface. |
63%, Good |
| Cary, 2016 [10]; General |
Benefits and challenges of delivering tele-rehabilitation services to rural veterans. |
Utility study: Qualitative design. |
Qualitative thematic analysis (2 therapist discussion groups). |
6 clinicians (17% male, one PT) providing telehealth services to veterans in their homes (TeleHOME project, North Carolina). |
In-home safety and mobility assessment by an occupational therapist/PT via telehealth with a LNP present. |
Synchronous VC, asynchronous photos/video recordings. Encrypted laptop/ iPad (Apple Inc, Cupertino, CA, USA) internal/USB webcam, Cisco/Jabber (Movi) (Cisco Systems Inc, San Jose, CA, USA), WiFi/wireless services, video camera & tripod. |
20%, Poor |
| Conlan, 2016 [44]; Women’s health |
An exploration of the efficacy of telehealth in the assessment and management of stress urinary incontinence among women in rural locations. |
Utility study: Case report. |
Descriptive with use of medians and frequencies. |
6 women (mean age 36.5yrs) with self-reported stress urinary incontinence from rural towns in Western Australia. |
Home setting. |
Synchronous VC and telephone consultations. PT used Microsoft LifeCam HD-3000 and Skype (Microsoft Inc, Seattle, WA, USA), and telephone. Participants used own device in their home. |
Case report, N/A |
| Cottrell, 2018 [45]; Advanced practice |
Agreement between telehealth and in-person assessment of patients with chronic musculoskeletal conditions presenting to an advanced-practice physiotherapy screening clinic. |
Interrater agreement study: Repeated measures. |
Descriptive statistics, diagnosis rated as same/similar/ different. Exact agreement, % specific agreement, Cohen’s κ and Gwet’s AC1. |
42 participants with lumber spine (n = 14), shoulder (n = 14) or knee (n = 14) conditions from a Neurosurgical & Orthopaedic Physiotherapy Screening Clinic (Brisbane). |
‘Simulated’ telehealth environment. F2F and telehealth assessments in separate rooms in the same hospital. |
Synchronous VC. Dell (Dell, Round Rock, TX, USA) computer connected to hospital's network, e-HAB TR videoconferencing (NeoRehab, Brisbane, Australia), participants used iPad (Apple Inc, Cupertino, CA, USA), stand and internet connection. |
88%, Very good |
| Cottrell, 2021 (First published July 2019) [46]; Advanced practice |
Comparing fly-in fly-out and telehealth models for delivering advanced-practice physiotherapy services in regional Queensland: An audit of outcomes and costs. |
Utility study: Retrospective electronic medical record audit. |
Descriptive statistics and cost comparison (average cost per slot), 95% CI, weighted average ratios and estimated net financial position. |
26 telehealth participants (62% female, mean age 53.8 ± 11.4yrs) with spinal injury. 18 F2F participants (83% female, mean age 46.6 ± 13.8yrs) with upper/ lower limb (72.2%) or spinal (27.8%) concerns. |
Telehealth assessment conducted in a regional facility with a graduate PT in attendance and clinical leader (PT with advanced training) located remotely in a metropolitan tertiary hospital. |
Limited details provided on the telehealth consultation including how assessment was conducted. Computer, webcam and Movi software (Cisco Systems Inc, San Jose, CA, USA) appear to have been used. |
80%, Very good |
| Cox, 2013 [47]; Cardio-respiratory |
Assessing exercise capacity using telehealth: a feasibility study in adults with cystic fibrosis. |
Feasibility and repeatability study. |
Paired t test (significance set to P<.05) and Bland and Altman mean (±SD). |
10 adults with cystic fibrosis (50% male, mean age 32 ± 7yrs), mean FEV1 = 55.4%. |
‘Simulated’ telehealth environment. F2F and telehealth assessments in separate rooms of the same building. |
Synchronous VC. Desktop computer, webcam, video-collaboration software (VSee, Sunnyvale, CA, USA), pulse oximeter, participants received pictorial and written instructions. |
75%, Good |
| Demmelmaier, 2010 [48]; Musculo-skeletal |
Physiotherapists' telephone consultations regarding back pain: a method to analyse screening of risk factors. |
Utility study: An exploratory study investigating PT telehealth assessments and the reliability of a research protocol. |
Descriptive statistics and means, ICC and κ values calculated pairwise to estimate agreement. |
5 PT’s (100% female, 25-55yrs, 3-31yrs clinical experience). 17 consultations were reviewed. |
Telephone consultations with patients calling a physiotherapy clinic in two urban communities in Sweden. No location details provided. |
Synchronous telephone telehealth consultation recorded using a Grundig Stenocassett Recorder (Dt 3400) (Grundig, Neu-Isenberg, Germany) or a ZAP Digital Voice Recorder-X1 and were transcribed verbatim. |
40%, moderate |
| Eannucci, 2020 [49]; General |
Patient satisfaction for telehealth physical therapy services was comparable to that of in-person services during the COVID-19 pandemic. |
Utility study: Retrospective review of survey data. |
Means, standard deviations, frequencies and % used with comparisons using one-way ANOVA and Chai squared. Kruskal-Wallis tests with significance = 0.05. |
1147 participants (67% female, mean age 60.3 ± 15yrs) receiving either F2F or telehealth services at the Hospital for Special Surgery. 133 initial and 104 follow-up physiotherapy telehealth consultations. |
Telehealth assessments occurring following shelter in place orders due to COVID-19. No further details regarding the telehealth assessment environment were provided. |
No details regarding the telehealth assessment delivery or technology used were provided. |
60%, good |
| Exum, 2020 [50]; Cardio-respiratory |
Applying telehealth technologies and strategies to provide acute care consultation and treatment of patients with confirmed or possible COVID-19. |
Utility study: Case report of the health care (including PT) response to COVID-19 in an acute care setting. |
Descriptive analysis. |
11 PT’s recruited in the COVID-19 response team involved in triage, developing telehealth assessment and intervention strategies where possible. |
Consultations performed remotely or outside patient’s room with therapist viewing consultation through a window where required. A registered nurse was with the patient when required. |
Synchronous VC or telephone consultations using Apple iPad/iPad Air 2 or 6th Generation iPad (Apple Inc, Cupertino, CA, USA), Microsoft Teams (Microsoft Inc, Seattle, WA, USA) and hospital provided laptop (Health Insurance Portability and Accountability Act compliant). |
N/A, case report |
| Funderskov, 2019 [51]; Palliative care |
Telemedicine in specialised palliative care: Healthcare professionals’ and their perspectives in video consultations – A qualitative study. |
Utility study: Explorative qualitative study of health professionals’ experiences. |
Malterud’s systematic text condensation with thematic coding and categorisation. |
8 health care professionals (one PT) were included in the study who had conducted 82 telehealth consultations for patients with severe illness. |
In-home consultations with community nurses in attendance and therapists attending remotely via telehealth. |
Synchronous VC using tablets provided to participants with Sim cards (able to accept 4G), desktop computer and developed App for relatives to participate when unable to be with the participant in person. |
80%, very good |
| Galiano-Castillo, 2014 [52]; Cancer care |
Agreement between telerehabilitation involving caregivers and face-to-face clinical assessment of lymphedema in breast cancer survivors. |
Criterion validity and inter-rater reliability study. |
Bland and Altman limits of agreement, mean difference, Cronbach's α and ICC’s (Rho). Inter-rater reliability determined by two-way random effect ICC coefficients (Rho) and CI’s. |
30 female breast cancer survivors (mean age 46.33 ± 9.05yrs, 66.7% lumpectomy, 26.7% unilateral mastectomy, 6.7% bilateral mastectomy). 80% unilaterally and 20% bilaterally affected. |
‘Simulated’ telehealth environment. Assessments were conducted on the same day within a 120-min interval at the University of Granada (Spain), with a caregiver completing the telehealth assessment. |
Synchronous VC with e-CUIDATE web-based system, internet connection (bandwidth 256 Kbit/s), two personal computers and Wormhole Web Conference (Wormhole IT, San Jose, CA, USA) and Skype software (Microsoft Inc, Seattle, WA, USA). |
100%, very good |
| Grona, 2017 [53]; Musculo-skeletal |
Case report: using a remote presence robot to improve access to physical therapy for people with chronic back disorders in an underserved community. |
Utility study: Case report. |
Descriptive using thematic analysis. |
45-y-old, female with a chronic back disorder (20yr history of low back pain, post L5-S1 microdiscectomy & laminectomy). |
LNP present during the assessment (same room as participant). PT joined via the remote presence robot. |
Synchronous VC via a remote presence robot (RP-7) (InTouch Health, Santa Barbara, CA, USA) which contained a screen (+ screen sharing), 2 × cameras and microphone. LNP was present. No further details provided. |
N/A, case report |
| Harland, 2017 [54]; Musculo-skeletal |
Physiotherapists and general practitioners’ attitudes towards 'PhysioDirect' phone based musculoskeletal physiotherapy services: a national survey. |
Utility study: Questionnaire based exploratory study capturing databased on a randomised controlled trial. |
Percentage response rates. |
541 PT (82% female, 23% working within and a phone-based service) and 68 general practitioner respondents who refer to these services (68% female). |
Telephone consultations with patients calling the PhysioDirect service from the United Kingdom (UK). |
Synchronous telephone physiotherapy service. No further details of technology provided. |
100%, very good |
| Hollinghurst, 2013 [55]; Musculo-skeletal |
A pragmatic randomised controlled trial of 'PhysioDirect' telephone assessment and advice services for patients with musculoskeletal problems: economic evaluation. |
Utility study: Economic evaluation and cost-utility analysis based on a randomised controlled trial. |
Frequencies, means, medians, Quality Adjusted Life Years & cost-effectiveness ratios (ICER), cost-effectiveness acceptability curve (CEAC) and net monetary benefit (NMB) estimated. |
1506 PhysioDirect and 743 usual care participants. This study used complete cost and QALY data for 840 PhysioDirect and 432 usual care participants. |
Telephone consultations occurred with participants (from Bristol, Somerset, Stoke-on-Trent and Cheshire) calling from their own home/community. Participants could call-back the service if required or wanted a F2F appointment. |
Synchronous telephone assessment/triage system which used computerised assessment templates at times. No further details of technology provided. |
20%, poor |
| Hwang, 2016 [56]; Cardio-respiratory |
Assessing functional exercise capacity using telehealth: is it valid and reliable in patients with chronic heart failure? |
Nested validity, inter- and intra-rater reliability study: Part of a randomised controlled trial investigating telehealth for heart failure. |
Mean difference, paired t tests, ICC and Bland and Altman limits of agreement. Inter- and intra-rater reliability of telehealth assessments were investigated using ICC. |
17 participants with stable chronic heart failure (88% male, mean age 69 ± 12yrs) with ischemic cardiomyopathy (65%), idiopathic cardiomyopathy (18%), heart failure (18%). |
‘Simulated’ telehealth environment. Assessments occurred in a hospital setting (Brisbane, Australia) on the same day with examiner in a separate room during the telehealth assessment. |
Synchronous VC (recorded for reliability) using laptop (Dell Inspiron 15), VC software (Adobe Connect 9.2) (Adobe Inc, San Jose, CA, USA), internet connection (3G wireless broadband). Participants received pictorial and written instructions on using the technology provided. |
69%, good |
| Kinder, 2019 [57]; Women’s health |
Telerehabilitation for treating pelvic floor dysfunction: a case series of 3 patients' experiences. |
Utility study: Case series with one participant completing a physiotherapy assessment via telehealth. |
Descriptive analysis. |
One female participant (41yrs, 4-mo postpartum) experiencing stress urinary incontinence, diastasis recti and needing pelvic floor muscle training. |
Conducted in a suburb/city. No further details provided. |
Synchronous VC using BlueJay Engage App (BlueJay Mobile Health, Livermore, CA, USA) which required setup and routine updates. Participant used their own iPhone device (Apple Inc, Cupertino, CA, USA). |
N/A, Case series |
| Lade, 2012 [58]; Musculo-skeletal |
Validity and reliability of the assessment and diagnosis of musculoskeletal elbow disorders using telerehabilitation. |
Validity and reliability study: Repeated measures. |
Descriptive analysis with percentage of exact or similar agreement, χ2 and weighted κ. |
10 participants (9 males, mean age 38 ± 13yrs), 11 elbow cases (1 × bilateral) recruited from a private musculoskeletal and Sports Injury Clinic (Queensland, Australia). |
‘Simulated’ telehealth environment. Participants were assessed in a single session, F2F and via telehealth (examiner in a separate room). |
Synchronous VC (with recording capabilities) using telerehabilitation system (eHAB, NeoRehab, Brisbane, Australia) allowing videoconferencing (320x240 pixels) and Wireless 3G internet connection. |
69%, good |
| Lovo, 2019 [59]; Musculo-skeletal |
Experience of patients and practitioners with a team and technology approach to chronic back disorder management. |
Utility study: Qualitative design based on a randomised controlled trial pilot study. |
Proportions, medians and interquartile ranges (IQR) of participants responses to a survey. |
19 participants (mean age 50.84 ± 13.87, 57.9% female) with low back ± leg pain. Six participants and two health practitioners (LNP and PT) participated in a semi-structured phone interview. |
A lumbar spine physiotherapy assessment was completed by an urban PT via telehealth. A LNP was in attendance with the participant. |
Synchronous VC using a laptop with VidyoDesktop Software Inc. (USA) and external camera (pan, tilt & zoom capabilities) at LNP and participant end. No further details provided. |
100%, very good |
| Mani, 2019 [60]; Musculo-skeletal |
Concurrent validity and reliability of telerehabilitation-based physiotherapy assessment of cervical spine in adults with non-specific neck pain. |
Concurrent validity, intra-rater and inter-rater reliability study: Repeated measures. |
Bland-Altman’s limit of agreement, standard error of measurement (SEM), coefficient of variation, minimal detectable changes, ICC, % agreement and χ2 stats. |
11 (8 females, mean age 32.7 ± 10.9yrs) with non-specific neck pain. Nine participant recordings were used for reliability analysis. |
‘Simulated’ telehealth environment (physiotherapy clinic, University Kebangsaan Malaysia). Participants accompanied by relative/friend or clinical assistant were assessed in a single session via F2F and telehealth (examiner in a separate location). |
Synchronous VC using TelePTsys system allowing videoconferencing (320x240 pixels) with e-Goniometer, e-Ruler and scheduling and reporting software. Digital image capture ability, MPEG-4 video and Speex audio codecs (Xiph.Org Foundation, Somerville, MA, USA) and 15.5-inch laptop with Logitech webcam (C310) (Logitech, Fremont, CA, USA), with inbuilt microphone with noise reduction (patient-end). |
77%, good |
| Mehta, 2020 (First published in October 2020) [61]; Musculo-skeletal |
Virtual assessments of knee and wrist joint range motion have comparable reliability with face-to-face assessments. |
Cross-sectional reliability study. |
Paired t tests (P < 0.05 significance), ICC with 2-way random effects model, SEM and Bland-Altman levels of agreement and mean difference. |
54 PT students and known acquaintances (30 females, mean age 24.5 ± 1.9 y) without musculoskeletal impairments of upper or lower limbs. |
‘Simulated’ telehealth environment. Assessment occurred in a single session in a University setting (USA). Virtual assessment first, followed by a F2F. |
Synchronous VC consultation using wall-mounted camera system, Zoom Cloud Meetings ® (Zoom Video Communications, Inc., San Jose, CA, USA), 12-inch and 6-inch 360 degrees universal goniometer (F2F only). Range of movement was visually estimated in the telehealth group. |
78%, good |
| Mukaino, 2020 [62]; Cardio-respiratory |
An affordable, user-friendly telerehabilitation system assembled using existing technologies for individuals isolated with COVID-19: Development and feasibility study. |
Utility study: Feasibility using a convenience sample with small telehealth assessment component. |
Descriptive analysis using means and standard deviations. |
10 participants (60% female, mean age 60 ± 18yrs) admitted to a University Hospital diagnosed with COVID-19. |
Telehealth assessment occurred in private isolated hospital room. |
Synchronous VC consultation using desktop and tablet computer, pulse oximeter (Ring 2, Neuroceutcal Inc), Zoom (Zoom Video Communications, Inc., San Jose, CA, USA), Skype (Microsoft Inc, Seattle, WA, USA) and Team Viewer (TeamViewer GmbH, Germany). |
40%, moderate |
| Nicola, 2018 [63]; Paediatrics |
The feasibility and concurrent validity of performing the Movement Assessment Battery for Children - 2nd Edition via telerehabilitation technology. |
Concurrent validity study using a test-retest method to compare telehealth with a F2F assessment. |
Agreement determined by mean absolute difference (MAD), % agreement and Bland-Altman limits of agreement. |
59 typically developing children (5-11 y, 28 females) attending a local public school (Queensland, Australia). |
Telehealth assessment conducted in a school setting with PT located off site (teacher aid was present at school). Both assessments occurred sequentially in one day when possible. |
Synchronous VC using the eHAB telerehabilitation system (NeoRehab, Brisbane, Australia) accessed at the school campus via an iPad (Apple Inc, Cupertino, CA, USA) and a portable 4G Wi-Fi hotspot. |
100%, very good |
| O’Donovan, 2020 [64]; Musculo-skeletal |
Telehealth for delivery of haemophilia comprehensive care during the COVID-19 pandemic. |
Utility study: Narrative design of a multi-disciplinary haemophilia service. |
Descriptive analysis. |
38 patients with severe haemophilia who obtain services from the European Haemophilia Comprehensive Care Centre responded to a survey about telehealth services. |
Telehealth assessments occurred remotely with 49% located in Dublin and 51% outside of Dublin. No further details provided. |
Telephone and VC using Blue Eye (RedZinc Service, Ireland) video communication system. |
N/A, narrative study |
| Palacin-Marin, 2013 [65]; Musculo-skeletal |
Agreement between telerehabilitation and face-to-face clinical outcome assessments for low back pain in primary care. |
Validity, inter- and intra-rater reliability study: Repeated measures crossover design. |
Bland-Altman limits of agreement, mean difference, Cronbach α and ICC. |
15 participants (6 males, mean age 37yrs). |
Participants attended a primary care centre where telehealth and F2F assessments were conducted using a set protocol. |
Synchronous VC (recorded for reliability) using TPLUFIB-WEB web-based system, Skype software (Microsoft Inc, Seattle, WA, USA), Logitech HD Pro webcam C920 (Logitech, Fremont, CA, USA), Kinovea software and computers. |
85%, very good |
| Pearson, 2016 [66]; Musculo-skeletal |
Acceptability to patients of PhysioDirect telephone advice and treatment services: a qualitative investigation. |
Utility study: Nested qualitative, within a randomised controlled trial. |
Thematic, cross-sectional analysis. |
82 participants (46% male, mean age 58yrs ±16.88) from the PhysioDirect randomised controlled trial were interviewed once (most at home), following an episode of service. |
Telephone consultations with participants (from Bristol, Somerset, Stoke-on-Trent and Cheshire) located in their home/community. Service users could call-back the service for support or a F2F appointment. |
Synchronous telephone assessment/triage system which used computerised assessment templates at times. No further details of technology provided. |
60%, good |
| Peterson, 2018 [67]; Musculo-skeletal |
Use of a modified treatment-based classification system for subgrouping patients with low back pain: agreement between telerehabilitation and face-to-face assessments. |
Repeated measures agreement study. |
Overall and frequency of percent agreement, κ coefficient and 95% CI. Wilcoxon signed-rank test examined significant difference, power, and effect sizes. |
47 participants (mean age 48.6 ± 15yrs, 30% male) with <90-d duration of low back pain symptoms recruited from two outpatient private practice clinics in Arizona. |
‘Simulated’ telehealth environment. All assessments completed in a private practice, 10-min apart within the same room. |
Synchronous VC using web-based teleconference application Zoom (Zoom Video Communications, Inc., San Jose, CA, USA), two personal computers and an iPad (Apple Inc, Cupertino, CA, USA) mounted with wide-angle lens and attached to a tripod. |
83%, very good |
| Prada, 2020 [68]; Neurological |
The suspected SARS-Cov-2 infection in a Charcot-Marie-Tooth patient undergoing postsurgical rehabilitation: the value of telerehabilitation for evaluation and continuing treatment. |
Utility study: Case report. |
Descriptive analysis. |
One participant (28yrs, male) with Charcot-Marie-Tooth post tendon transfer surgery transitioned to telehealth services after contracting COVID-19. |
Assessment occurred remotely after showing signs of COVID-19. No further specific details on location provided. |
Synchronous VC using publicly available software. No further details provided. |
N/A, case report |
| Richardson, 2017 [69]; Musculo-skeletal |
Physiotherapy assessment and diagnosis of musculoskeletal disorders of the knee via telerehabilitation. |
A criterion validity, inter-and intra-rater design: repeated measures. |
Percentage exact agreement, percentage similar agreement, χ2 or weighted κ and descriptive analysis. |
18 participants (8 males, mean age 23 ± 7yrs) with knee pain presenting to a private practice (Brisbane, Australia). |
‘Simulated’ telehealth environment. Assessed in one session using F2F and telehealth methods (10min break between). Assessment items chosen by examiners. Telehealth assessment was carried out by a remote PT (location unspecified). |
Synchronous VC (recorded for reliability) using eHAB TR system (Version 2; NeoRehab, Brisbane, Australia), Wi-Fi broadband connection on 3G mobile network and pre-recorded video and still images used for demonstration purposes. |
62%, good |
| Russell (a), 2010 [4]; Musculo-skeletal |
The diagnostic accuracy of telerehabilitation for non-articular lower-limb musculoskeletal disorders. |
A validity, inter-rater and intra-rater design: repeated measures. |
χ2 or weighted κ and percentage of exact agreement or percentage of similar agreement and descriptive statistics. |
19 participants (5 males, mean age 26 ± 13yrs, from a university student population) presenting to a private practice (Brisbane, Australia) with lower limb pain. |
‘Simulated’ telehealth environment. Assessed in one session with F2F and telehealth assessment methods (location unspecified). Assessment items chosen by examiners. |
Synchronous VC (recorded for reliability) using eHAB TR system (Uniquest, Brisbane, Australia), remote camera pan and zoom features and 3G Internet connections (Telstra Next G; Melbourne, Australia). |
85%, very good |
| Russell, 2013 [70]; Neurological |
Internet-based physical assessment of people with Parkinson disease is accurate and reliable: a pilot study. |
Validity, inter-rater and intra-rater reliability study: simultaneous assessment. |
Bland and Altman limits of agreement and MAD, weighted κ scores, ICC’s, percentage exact agreement and agreement within one point (%A±1). |
12 participants (50% male, mean age 66.1 ± 8.5yrs) with Parkinson disease (rated I-IV on Hoehn & Yahr Score). |
‘Simulated’ telehealth environment. Participants assessed via telehealth and F2F simultaneously (location unspecified). Two therapists were in the same room as the participant (remote therapist was located in an alternate room). |
Synchronous VC (recorded for reliability) using eHAB TR system (Uniquest, Brisbane, Australia), and 3G Internet connections (Telstra Next G; Melbourne, Australia). |
69%, good |
| Russell (b), 2010 [71]; Musculo-skeletal |
Telerehabilitation mediated physiotherapy assessment of ankle disorders. |
Validity, inter-rater and intra-rater design: repeated measures. |
Percentage agreement, weighted κ, Percentage exact agreement, percentage similar agreement and χ2. |
15 participants (5 males, mean age 24.5 ± 10.8yrs) who presented to a musculoskeletal clinic (Brisbane, Australia) with ankle pain were included. |
‘Simulated’ telehealth environment. Participants attended a single session. F2F and remote assessments completed with 10min break between methods. Assessment items chosen by examiners. |
Synchronous VC (recorded for reliability) using eHAB TR system (Uniquest, Brisbane, Australia), 3G Internet connections (Telstra Next G; Melbourne, Australia) with pre-recorded videos of tasks shown to participants as required ie, ligament stability tests. |
77%, good |
| Salisbury, 2013 [72]; Musculo-skeletal |
Effectiveness of PhysioDirect telephone assessment and advice services for patients with musculoskeletal problems: pragmatic randomised controlled trial. |
Utility study: Based on a Randomised controlled trial comparing PhysioDirect to usual care. |
Descriptive statistics and multivariable regression models. |
1506 participants (PhysioDirect) and 743 (usual care) (40% male, mean age 60yrs) with 30% lower limb, 27% lumbar spine, 14% thoracic or cervical spine and 23% upper limb concerns. |
Participants in the PhysioDirect group were invited to contact PT’s by telephone within specified days/times to access the service from home, place of work or other area within the community. |
Synchronous telephone assessment/triage system using computerised assessment templates at times. Following the initial telephone consultations, participants could call-back the service if they had further problems or wanted to request a F2F appointment. |
80%, very good |
| Steele, 2012 [73]; Musculo-skeletal |
Assessment and diagnosis of musculoskeletal shoulder disorders over the internet. |
Validity, inter-rater and intra-rater reliability design: repeated measures. |
Percentage agreement (same, similar and different) and percentage exact and close agreement χ2 and weighted κ. |
22 participants and 28 assessments (16 males, mean age 30.7 ± 14.2yrs, some with bilateral shoulder pain). Participants (students and staff) were recruited from the University Musculoskeletal Clinic. |
‘Simulated’ telehealth environment. Participants underwent a F2F and telehealth assessment in one session (Queensland, Australia). Examiner was in an alternate room and chose the assessment items. |
Synchronous VC (recorded for reliability) using the eHAB TR system (Neorehab, Brisbane, Australia) and 3G Internet connections (Telstra Next G; Melbourne, Australia). |
92%, very good |
| Truter, 2014 [74]; Musculo-skeletal |
The validity of physical therapy assessment of low back pain via telerehabilitation in a clinical setting. |
Validity study: repeated measures. |
χ2 tests, percentage exact agreement, Pearson correlation (r), Paired t test and κ (level of significance, P<0.05). |
26 participants (11 males, mean age 43yrs) presenting with low back pain from a regional town (Queensland, Australia). |
‘Simulated’ telehealth environment. Participants attended telehealth and F2F assessments in one session (10-15mins apart) at a rural hospital. A friend/ allocated untrained helper assisted. |
Synchronous VC using eHAB system (version 2, Neorehab, Brisbane, Australia) with recording capability, store and forward images, remote camera pan, zoom and 3G Internet connections (Telstra Next G; Melbourne, Australia). |
100%, very good |
| Turner, 2018 [75]; Musculo-skeletal |
The validity of physical therapy assessment of low back pain via telerehabilitation in a clinical setting. |
Utility study: Case series design. |
Descriptive analysis. |
3 participants (45yr old male with LBP, a 49yr old female with right sided upper cervical pain and a 50yr old male with right lateral elbow pain). |
Rural hospital setting. Elements of the assessment were completed asynchronously prior to the telehealth appointment. |
Synchronous VC. Using participants own smartphone or tablet devices with internet connection, encrypted HIPAA compliant application (not specified) and a laptop with secure internet connection (clinician). |
100%, very good |
| Wood, 2017 [76]; Cardio-respiratory |
Telehealth clinics increase access to care for adults with cystic fibrosis living in rural and remote Western Australia. |
Utility study: Single group. |
Descriptive, paired t tests, Wilcoxon signed rank tests used. Positive or negative binomial regression compared utilisation data. |
23 adults with cystic fibrosis (61% female, mean age 31.4 ± 10.2yrs) living in rural or remote areas of Western Australia. 17 participants responded to the survey. |
Telehealth clinic located at the participants nearest regional hospital with clinic staff calling in remotely from Perth (Australia). |
Synchronous VC using Polycom HDX ® series (Polycom, San Jose, USA). |
100%, very good |
| Wootton, 2020 [77]; Cardio-respiratory | COVID-19 rehabilitation delivered via a telehealth pulmonary rehabilitation model: a case series. | Utility study: Case series. | Descriptive analysis. | 3 participants (100% male, ages 59-80) who tested positive for COVID-19. | Assessments completed in the home setting with therapist in an alternate location. | Synchronous VC used to administer the exercise test and review intervention. Questionnaires were completed asynchronously. Participants used their own device. Oxygen saturation and heart rate monitors were sent to their home prior to the assessment. | N/A, case series |
F2F – face-to-face, LNP – licensed nurse practitioner, VC – videoconference, N/A – not appraised, PT – physiotherapist, TR – telerehabilitation