MEASURING CERVICAL ROTATION VIRTUALLY DURING TELEHEALTH

W. Ge^1,2, K. Morrell¹, A. Varrecchia¹

Background: In the wake of the 2019 Novel Coronavirus Disease (COVID-19) outbreak, digital physical therapy practice has made significant advancements in telehealth. In physical therapy practice, objective information obtained from patients, such as clinical measurement of range of motion (ROM), is a fundamental evaluation procedure to achieve high quality of care. During telehealth, it could be challenging for physical therapists to measure cervical rotation virtually for evaluation. Theoretically, cervical rotation can be measured from the top view video or photo virtually but that may not be feasible for most patients during telehealth. The difficulty in obtaining objective measurement of neck rotation virtually is a major barrier to high-quality services in digital physical therapy and telehealth.

Purpose: The purpose of the project was to develop an approach for measuring cervical rotation virtually from front view photograph or video conferencing during telehealth.

Methods: Due to the on-going social distancing restrictions, subjects were recruited from physical therapy faculty and students and their family or friends by emails, text messages, or social media using convenience sampling. The research design was a cross-sectional, non-experimental observational study. Subjects (family or friends) were instructed to sit in a chair with back supported and face a computer connected with the computer of the investigators through a video conferencing platform. The subjects were instructed to rotate the neck from 0° to the end range with increments of 10° to the left or right when a screenshot was taken. The distance between the subject’s eyes was obtained using ImageJ. Cervical rotation (CROM) was calculated using the distance in each screenshot based on trigonometry. Descriptive analysis, Pearson correlation, and Bland-Altman analysis were used to analyze the data.

Results: The mean CROM was 0.0 (SD 0.0), 14.3 (SD 3.4), 28.5 (SD 5.1), 39.9 (SD 5.9), 49.2 (SD 6.5), 57.7 (SD 6.8), 65.5 (SD 6.9), 72.6 (SD 5.5), and 80.8 (SD 3.7) ° for each position from 0 to 80°, respectively. Pearson correlation coefficient (r) was 0.99, indicating a very high correlation. The Bland-Altman analysis revealed that 91.7% (111 out of 121) of the CROM fell within the limits of agreement (95% confidence interval).

Conclusion(s): The results provide a novel and feasible approach for measuring cervical rotation virtually during digital physical therapy practice and telehealth. It can serve as the foundation for a computerized comprehensive full-body ROM measurement system for digital physical therapy and telehealth during the COVID-19 pandemic and beyond.

Implications: To our knowledge, this was the first study on cervical rotation measurement during telehealth to address an urgent need in advancing digital physical therapy practice and telehealth during the COVID-19 pandemic and beyond. It does not require additional devices such as a smartphone or tablet so it would work well for the majority of the patients. That is very important for some patients who may be technophobia or may not even own a device. The approach is more inclusive which can decrease disparity in telehealth. The results may contribute to high-quality services in digital physical therapy and telehealth during COVID-19 pandemic and years to come.

Funding, acknowledgements: None.

Keywords: telehealth, range of motion, spine

Topic: COVID-19

Did this work require ethics approval? Yes

Institution: Youngstown State University

Committee: Institutional Review Board

Ethics number: 166-20