A recent study compares the impact of the TheraNow telehealth physical therapy program on hospital readmission-rate post major joint replacement surgery.

1. Peer-reviewed, prospective cohort study published in the Journal of Pharmaceutical Research International (JPRI) is the first to compare the impact of the telehealth physical therapy program on hospital readmission-rate post major joint replacement surgery [1].
2. The TheraNow telehealth physical therapy program reported a 2.5% hospital readmission rate in the first 30 days of the physical therapy program for major joint replacement surgeries compared to a national hospital readmission rate of 3.3%-5.6% in 30 days post-surgery [2].
3. Findings demonstrate the ability of TheraNow virtual physical therapy and rehab platform to provide scalability and cost-effectiveness across patients without outpatient clinic PT or home health PT [3,4,5].
4. Hospitals, medical practices, health plans, and their patients can benefit from telehealth physical therapy programs with lower readmission rate, lower costs, and improved outcomes.
5. Results validate telehealth physical therapy to joint replacement rehabilitation as a convenient, scalable, less costly approach that complements in-person or remote physical therapy appointments.

Joint replacement surgery is cost-effective and clinically relevant in appropriately selected patients. As per a recent report, total joint replacement use will increase by 71% from 2018 to 2030 [6]. Preoperative health status (e.g., greater muscle strength and capacity to complete activities of daily living) directly correlate with perioperative outcomes after total joint replacements [7].

Preoperative and postoperative care for patients with total joint replacement is generally adequate for reducing pain intensity and readmission rate. Successful rehabilitation improves pain control, gait, balance and strength, and reduces the recovery time [8,9]. Though less commonly used, pre-habilitation (before surgery) has also been recommended [10]. In addition, preoperative health status is a strong predictor of favorable postoperative outcomes [11]. Thus, recovery and rehabilitation are crucial stages after knee and joint replacement surgeries. Physical therapy (PT) after surgery is one of the essential modalities that hasten recovery. The traditional physical therapy methods are outpatient clinic PT or home health PT. However, the current evolving technology has led to various digital solutions. One such program is the TheraNow telehealth physical therapy program which offers care on a specialized virtual rehabilitation platform with licensed and trained virtual care physical therapists.

Power of Telehealth in Physical Therapy

TELE-REHAB is another promising and upcoming segment in telehealth and telemedicine. Rehabilitation visits are typically more frequent and necessary. But can this be done from the comfort of a patient’s home? Again, the answer is YES; it is possible. These services can be related to any rehabilitation, including Physical Therapy, Occupational Therapy, Speech Therapy, Psychotherapeutic counseling, women’s health associated with prenatal and post-natal care, or any other condition requiring rehabilitation.

The best part of tele-rehab is that the patients are not required to drive for the appointments or spend time in the waiting room of the clinics. This mode of patient care is beneficial for geriatric (old-age) patients who are unable to attend rehab on a frequent/daily basis.

Soon, the way technology is evolving, tele-rehab will be the most preferred form of treatment. However, of note, this is not a replacement to conventional treatment methods but just another mode of treatment with its own unique benefits. As patients get more proactive with technology for managing health, alternative care methods involving telemedicine will keep evolving and improvising. Furthermore, this healthcare delivery model empowers patients to be in charge of their health by educating patients in a better prevention approach.

The JPRI study validates that the TheraNow Virtual physical therapy and rehab platform significantly lowers hospital readmission rates after major joint replacement surgeries.

Key JPRI study highlights [1]:

1. Forty enrolled patients with 65.2 years of average age. 23 (57.5%) were female, while 17(42.5%) were males.
2. The program incorporated three phases of rehabilitation: pre-rehabilitation, post-surgical rehabilitation, and functional rehabilitation. Physical Therapists provided customized therapy to every patient with a duration of 45-60 minutes of personalized sessions via telehealth using synchronous video visits for 6-8 weeks.
3. The study tracked and identified all hospital readmissions within 30 days of discharge from the patients’ medical records.
4. The TheraNow telehealth physical therapy program reported a 2.5% readmission rate in the first 30 days of the physical therapy program for major joint replacement surgeries compared to a national hospital readmission rate of 3.3%-5.6% in 30 days post-surgery.

 

References:

1. Kohli, R. and Gupta, A. (2022) “Impact of TheraNow Telehealth Physical Therapy Program on Hospital Readmission Rate Post Major Joint Replacement Surgery”, Journal of Pharmaceutical Research International, 34(3A), pp. 35-41. doi: 10.9734/jpri/2022/v34i3A35561.
2. Ramkumar PN, Chu CT, Harris JD, Athiviraham A, Harrington MA, White DL, Berger DH, Naik AD, Li LT. Causes and rates of unplanned readmissions after elective primary total joint arthroplasty: A Systematic Review and Meta-Analysis. Am J Orthop (Belle Mead NJ). 2015 Sep;44(9):397-405.
3. Tousignant M, Boissy P, Corriveau H, Moffet H. In home telerehabilitation for older adults after discharge from an acute hospital or rehabilitation unit: a proof-of-concept study and costs estimation. Disabil Rehabil Assist Technol. 2006 Sep;1(4):209-16.
4. Tousignant M, Moffet H, Nadeau S, Mérette C, Boissy P, Corriveau H, Marquis F, Cabana F, Ranger P, Belzile ÉL, Dimentberg R. Cost analysis of in-home telerehabilitation for post-knee arthroplasty. J Med Internet Res. 2015 Mar 31;17(3):e83.
5. Moffet H, Tousignant M, Nadeau S, Mérette C, Boissy P, Corriveau H, Marquis F, Cabana F, Belzile ÉL, Ranger P, Dimentberg R. Patient satisfaction with in-home telerehabilitation after total knee arthroplasty: results from a randomized controlled trial. Telemed J E Health. 2017 Feb;23(2):80-7. Epub 2016 Aug 16.
6. Sloan M, Premkumar A, Sheth NP. Projected volume of primary total joint arthroplasty in the U.S. 2014 to 2030. J Bone Joint Surg Am. 2018;100(17):1455-1460.
7. Fortin PR, Clarke AE, Joseph L, et al. Outcomes of total hip and knee replacement: preoperative functional status predicts outcomes at six months after surgery. Arthritis Rheum. 1999;42(8):1722-1728.
8. Doma K, Grant A, Morris J. The Effects of Balance Training on Balance Performance and Functional Outcome Measures Following Total Knee Arthroplasty: A Systematic Review and Meta-Analysis. Sports Med. 2018 Oct;48(10):2367-85.
9. Wu JQ, Mao LB, Wu J. Efficacy of exercise for improving functional outcomes for patients undergoing total hip arthroplasty: A meta-analysis. Medicine (Baltimore). 2019 Mar;98(10):e14591.
10. Snow R, Granata J, Ruhil AV, et al. Associations between preoperative physical therapy and post-acute care utilization patterns and cost in total joint replacement. J Bone Joint Surg Am. 2014 Oct 1;96(19):e165.
11. Fortin PR, Clarke AE, Joseph L, et al. Outcomes of total hip and knee replacement: preoperative functional status predicts outcomes at six months after surgery. Arthritis Rheum. 1999 Aug;42(8):1722-8.