REMOTE PATIENT MONITORING AS AN ADJUNCT TO TRADITIONAL PHYSICAL THERAPY: DOES IT WORK FOR HOME THERAPY?

Y. Shishani¹, L. Higgins², R. Gobezie¹

Background: Digital health has been recently introduced into the healthcare delivery pathway for physical therapy in many practices as a result of COVID-19. Digital health is comprised of telehealth and remote patient monitoring (RPM). Telehealth is used broadly presently. However, RPM has very limited implementation as a digital health technology in physical therapy practices. RPM is a technology that is being explored in order to assist in-home exercise programs, objectify patient compliance, collect valuable data, and generate additional ancillary revenue.

Purpose: The purpose of this study was to evaluate RPM for home exercise programs as an adjunct for patients doing traditional in-office physical therapy.

Methods: Between January-July 2019, we identified and consented 124 patients to use PTG for home-based exercises in conjunction with their regular in-office therapy visits. Each patient was placed on a standardized protocol for 2 different procedures: reverse total shoulder replacement and biceps tenodesis. Patients were trained on the device and instructed to perform their home exercises twice daily. The patients were monitored daily on a patient dashboard which is part of the PT Genie platform. A control group (CG) of patients having traditional physical therapy and home exercise programs had their data collected using Surgical Outcomes System (SOS). All patients underwent surgery by a fellowship-trained shoulder surgeon at a single facility.

Results: The average age of PTG users was 58 years (16-79). There were 43 female users. Sixty-five patients used PTG on their right shoulders. Most patients who used PTG underwent a biceps tenodesis (47%). Seventy-eight patients (78%) who used PTG were able to complete the prescribed rehab protocol in the PTG system. Seventy patients (70%) who used PTG reported a significant decrease in pain levels from initial session. At 6 weeks post-OP, the decrease in pain was more than 50% in PTG users compared to 41% in a similar CG with no use of PTG (p=0.001). Sixty patients (60%) of PTG users achieved their therapy goals at an average of 4.6 weeks after using PTG compared to 14 weeks in traditional non-PTG CG. PTG users reported an average ASES score of 80.4 at 3 months post-op compared to 71.3 for the CG (p=0.001). Seventy patients (70%) reported satisfaction with their overall progress and the benefit of adding PTG to their rehab protocol.

Conclusion(s): This study demonstrates that remote patient monitoring as an adjunct to traditional physical therapy may increase patient compliance and result in a more rapid recovery from shoulder surgery.  The results of this study demonstrate that outcomes for patients using RPM were better for ASES score, pain, and patient satisfaction. Further study will be required in order to determine if these results can be validated in a larger group over a longer period of time and with different types of procedures.  

Implications: As COVID-19 continues to disrupt access to physical therapy, clinicians continue to find ways to stay connected with patients to ensure appropriate performance of home-based therapy. It is essential to use available technology to help patients recover and resume daily activity under direct guidance from their therapists.

Funding, acknowledgements: Self-funded

Keywords: Remote Patient Monitoring, Digital Health, Physical Therapy

Topic: Orthopaedics

Did this work require ethics approval? Yes

Institution: Cleveland Shoulder Institute

Committee: Salus IRB

Ethics number: Protocol# 100