SUCCESSES AND BARRIERS TO PROVIDING VESTIBULAR PHYSIOTHERAPY SERVICES VIA TELEHEALTH DURING THE COVID-19 PANDEMIC

R. Harrell¹, M. Schubert², S. Oxborough³, S. Whitney¹

¹The University of Pittsburgh, Department of Physical Therapy, Pittsburgh, United States, ²The Johns Hopkins University, School of Medicine, Baltimore, United Kingdom, ³National Dizziness and Balance Centers, Bloomington, United States

Background: The Covid-19 pandemic caused a global shift in the way health care was delivered, moving from a mostly in-person model for care to telehealth and virtual visits for persons with balance and dizziness disorders.

Purpose: The purpose of the study was to investigate the successes and barriers of delivering vestibular physiotherapy services via telehealth both in the United States and globally via a survey of practicing clinicians.

Methods: A survey was created using previously validated telehealth surveys. A focus group of five US-based physical therapists was convened to ensure appropriate questions were integrated into the survey. The survey consisted of 70 questions that were divided into four sections: nine questions regarding therapist perceived effectiveness of telehealth, 35 regarding comfort level with the treatment of dizziness and balance diagnoses via telehealth, 18 on barriers experienced during telehealth sessions, and eight demographic questions. There were 20 responses from physiotherapists from five countries outside of the US (India, New Zealand, South Africa, Chile, and India). The 20 international survey respondents were matched for years of physical therapy experience with 20 US-based physical therapists for a total of 40 participants. This survey was distributed through the Academy of Neurologic Physical Therapy, through posts on social media, and via seven chapters of the American Physical Therapy Association. Data were analyzed through response frequencies and paired t-tests.

Results: There were no significant differences (p>0.05) between US and international responses to any of the questions regarding barriers to providing telehealth rehabilitation. Comments relaying success using telehealth included: “it was good for patients that lived far from vestibular specialists, it accommodated for patient’s busy work and personal lives, and allowed for screening of their home environment”. The most commonly reported barriers to using telehealth were exam related and included the inability to see the entire body of the patient during movement exam (85% for US and 80% for international respondents) and a lack of a caregiver being present (95% for and 75% for international respondents). Overall, when asked if physiotherapists had a sense that telehealth visits were as effective as in-person visits only 10% of US physical therapists and 25% of international physiotherapists agreed that telehealth visits were as effective as in-person visits.

Conclusions: Overall there were no differences between US-based and international physiotherapists in terms of barriers to providing telehealth vestibular rehabilitation services. There was a consensus that for some patients’ access to telehealth was beneficial to their care.[MCS1] While the physiotherapists rated that barriers were minimal, both international and US-based respondents reported that telehealth was not as effective as in-person sessions.

Implications: COVID-19 is a global pandemic causing healthcare around the world to shift to a virtual platform. This survey showed the advantages and barriers therapists faced while providing vestibular telehealth. More investigation is required to determine how to improve the efficacy of telehealth for persons with vestibular disorders.

Funding acknowledgements: No funding disclosures to report

Keywords:
COVID-19
Vestibular therapy
Telehealth

Topics:
COVID-19
Professional issues

Did this work require ethics approval? Yes

Institution: University of Pittsburgh in Pittsburgh PA, USA

Committee: Biomedical IRB

Ethics number: STUDY21020099