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 Table of Contents  
LETTER TO THE EDITOR
Year : 2020  |  Volume : 34  |  Issue : 3  |  Page : 217-218

Role of telerehabilitation in musculoskeletal conditions during COVID-19 pandemic


1 Department of Orthopaedic Surgery, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
2 District Early Intervention Centre of Excellence, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
3 Department of Physiotherapy, Mass College of Paramedical Science, Taj Hospital, Aligarh, Uttar Pradesh, India
4 Physiocare Clinic, Lucknow, Uttar Pradesh, India

Date of Submission30-Sep-2020
Date of Acceptance03-Nov-2020
Date of Web Publication28-Dec-2020

Correspondence Address:
Dr. Amir Ateeq
Department of Orthopaedic Surgery, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh - 202 002, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijpn.ijpn_136_20

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How to cite this article:
Ateeq A, Jahan N, Alam MF, Khanum F. Role of telerehabilitation in musculoskeletal conditions during COVID-19 pandemic. Indian J Pain 2020;34:217-8

How to cite this URL:
Ateeq A, Jahan N, Alam MF, Khanum F. Role of telerehabilitation in musculoskeletal conditions during COVID-19 pandemic. Indian J Pain [serial online] 2020 [cited 2021 Apr 12];34:217-8. Available from: https://www.indianjpain.org/text.asp?2020/34/3/217/305140



Sir,

The COVID-19 pandemic has led to unprecedented challenges and dilemmas for physiotherapists in relation to physical exercise procedures, continuation of education, and research around the world. The global coronavirus is reminding us the importance of telehealth to deliver rehabilitation services. Implementing telehealth proactively rather than reactively is more likely to generate greater benefits in the long term and help with the everyday (and emergency) challenges in health care.[1] Several states in India have adopted safety and social distancing measures to prevent infection and to further minimize the risk of community transmission through manual contact. Telerehabilitation [Figure 1] is the common term utilized by the physiotherapist internationally for telehealth applications. Telephysiotherapy is the technology used for virtual visit consultations and protocols, which makes use of information and communication to facilitate rehabilitation of patients who are confined in their homes. It is an ultimate tool to provide high-quality personalized musculoskeletal physiotherapy practice in the society and an effective way to reduce crowding of patients and accompanying persons in clinics/hospitals at this crucial time of COVID pandemic.
Figure 1: Telerehabilitation at work

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Despite the significant benefits, a number of challenges in the implementation of telephysiotherapy have been identified in developing countries like India such as underdeveloped infrastructure (poor energy and inadequate power supply, network issues, and shortage of multimedia devices), lack of comprehensive training for professionals, ethical issues (professional licensing, liability and malpractice, privacy, confidentiality, culture, environmental stigma, abuse, and quackery), and financial implications (affordability of mobile phones and reimbursement of rendered services). Complex optical image, sensor-based technologies, and virtual reality-based telerehabilitation systems have eroded these barriers in the last decade in developed countries.[2] Knee osteoarthritis causes musculoskeletal pain and disability affects up to one-third of people aged over 60 years. High-quality evidence has suggested that therapeutic exercise to strengthen muscles can significantly reduce pain and improve physical function and the quality of life (Qol). A health-related survey (36-item short questionnaire) to assess Qol recommends physical, psychological, and social domains of health. It refers to cognitive factors including coping, self-efficacy, somatization, pain catastrophizing, and helplessness and behavioral factors include kinesiophobia (pain related fear of movement) and pain-related fear avoidance.[3] Moderate quality of intervention and positive impact on health outcomes and satisfaction noted in musculoskeletal conditions in a systematic review of telehealth video conferencing physiotherapy.[4]

University of Queensland (Australia) and the University of Sherbrooke (Canada) practiced physiotherapy, occupational therapy and speech therapy under the supervision of clinical educators at their state art of telerehabilitation clinial. Theory and practical aspects were introduced via teleheath online learning modules for the academic purpose to develop unique skill through hands-on practicum, in which students and clinical educators worked through clinical cases.[5] PhysioDirect, a united kingdom-based telephone-delivered physiotherapy service, has proven equally effective as usual treatment for people with musculoskeletal conditions. Telephysiotherapy is more accessible and affordable and does not require access to a computer or Internet and does not even require skills needed to operate high tech gadgets. It may therefore mitigate the clinical, economical, and social burden in the society and in some ways revolutionize the practice of physiotherapy in future.[6] Physiotherapists have proven their resilience and professional dedication to stand firm with other health-care professionals as a frontline rehabilitative team.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Smith AC, Thomas E, Snoswell CL, Haydon H, Mehrotra A, Clemensen J, et al. Telehealth for global emergencies: Implications for coronavirus disease 2019 (COVID-19). J Telemed Telecare 2020;26:309-13.  Back to cited text no. 1
    
2.
Odole AC, Odunaiya NA, Ojo OD, Afolabi K. Tele-physiotherapy in Nigeria: Perceived challenges by physiotherapists to its implementation. Int J Telemed Clin Pract 2015;1:186-96.  Back to cited text no. 2
    
3.
Briani RV, Ferreira AS, Pazzinatto MF, Pappas E, Silva DD, de Azevedo FM. What interventions can improve quality of life or psychosocial factors of individuals with knee osteoarthritis? A systematic review with meta-analysis of primary outcomes from randomised controlled trials. Br J Sports Med 2018;52:1031-8.  Back to cited text no. 3
    
4.
Lee AC, Davenport TE, Randall K. Telehealth Physical Therapy in Musculoskeletal Practice. J Orthop Sports Phys Ther 2018;48:736-9.  Back to cited text no. 4
    
5.
Grona SL, Bath B, Busch A, Rotter T, Trask C, Harrison E. Use of videoconferencing for physical therapy in people with musculoskeletal conditions: A systematic review. J Telemed Telecare 2018;24:341-55.  Back to cited text no. 5
    
6.
Lawford BJ, Delany C, Bennell KL, Hinman RS. “I was really sceptical. But it worked really well”: A qualitative study of patient perceptions of telephone-delivered exercise therapy by physiotherapists for people with knee osteoarthritis. Osteoarthritis Cartilage 2018;26:741-50.  Back to cited text no. 6
    


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