Telehealth Rehabilitation for Ankle Sprains
Recruiting in Palo Alto (17 mi)
Age: < 65
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: Kyle Kosik
Disqualifiers: Concomitant injury, Lower extremity surgery, others
No Placebo Group
Approved in 3 Jurisdictions
Trial Summary
What is the purpose of this trial?A vast majority (75-85%) of ankle sprain patients treated in emergency departments (ED) receive pain medication and are not referred for physical rehabilitation. Therefore, purpose of this study is to increase access to the standard of care for an ankle sprain by provide patients with physical rehabilitation delivered through telehealth. The purpose of this study includes compare a 2-week telehealth intervention to the usual care for treating 1) subjective function; 2) physical impairments; 3) medication consumption; and 4) patient-perceived barriers. The central hypothesis is participants receiving the 2-week telehealth intervention will 1) have less pain and disability; 2) improve balance and ankle range of motion; 3) consume less medication; and 4) reports positive feedback compared to the usual care group.
Will I have to stop taking my current medications?
The trial does not specify if you need to stop taking your current medications, but it aims to reduce medication use through telehealth rehabilitation. It's best to discuss this with the trial coordinators or your doctor.
What data supports the effectiveness of the treatment Telehealth Delivered Physical Rehabilitation for ankle sprains?
Research shows that telehealth physical therapy is as effective as in-person therapy for various musculoskeletal issues, providing high-quality care and patient satisfaction. This suggests that telehealth rehabilitation could be a promising option for treating ankle sprains.
12345Is telehealth rehabilitation generally safe for humans?
Research shows that telehealth rehabilitation, including virtual physical therapy, is generally safe for humans. Studies have reported high levels of comfort and confidence among clients and therapists, although some barriers like ensuring patient safety without a caregiver present have been noted.
12678How is Telehealth Delivered Physical Rehabilitation unique for treating ankle sprains?
Telehealth Delivered Physical Rehabilitation is unique because it allows patients to receive physical therapy remotely through real-time videoconferencing, making it accessible for those in remote areas or with mobility issues. This approach offers convenience and continuity of care without the need for in-person visits, which can be particularly beneficial for managing conditions like ankle sprains.
1591011Eligibility Criteria
This trial is for men and women aged 15-35 who've been diagnosed with a mild to moderate acute lateral ankle sprain in the last 72 hours, haven't had recent lower extremity surgery or injuries affecting balance and gait, speak English, and have not received physical therapy referrals.Inclusion Criteria
I was diagnosed with a mild to moderate ankle sprain and left the emergency department without a referral for physical therapy.
You can join the study if you haven't injured your ankle in the last six months. But if you have, you can still join if it happened more than six months ago and you've fully recovered. This helps make sure everyone in the study has similar experiences with ankle injuries.
All race and ethnic groups
+1 more
Exclusion Criteria
I have had surgery or conditions affecting my walking and balance, not including an ankle sprain.
I have been diagnosed with another injury, like a fracture.
I do not speak English.
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
1-2 weeks
Treatment
Participants receive a 2-week telehealth intervention with 5 live-video sessions for physical rehabilitation
2 weeks
5 visits (virtual)
Follow-up
Participants are monitored for changes in balance, medication consumption, and other outcomes post-intervention
4 weeks
Weekly phone interviews
Participant Groups
The study compares usual care with a new telehealth protocol over two weeks. It aims to see if the telehealth approach improves function, reduces pain and medication use, enhances balance and range of motion, while also assessing patient-perceived barriers.
2Treatment groups
Experimental Treatment
Active Control
Group I: 2-week Telehealth ProtocolExperimental Treatment1 Intervention
Participants randomized to this arm will receive 5 live-video sessions. The first 2 live-video sessions will occur during the first week, last 20 minutes each and separated by 48-72 hours. The last 3 live-video sessions will occur during the second week, last 30-minutes each and separated by 24-48 hours.
Group II: 2-week Usual CareActive Control1 Intervention
The usual care group will be used to reflect the current care provided to patients after discharged from the emergency department for an ankle sprain.
Telehealth Delivered Physical Rehabilitation is already approved in United States, European Union, Canada for the following indications:
🇺🇸 Approved in United States as Telehealth Physical Therapy for:
- Ankle sprains
- Musculoskeletal injuries
- Orthopedic conditions
🇪🇺 Approved in European Union as Telemedicine Physical Rehabilitation for:
- Ankle sprains
- Musculoskeletal injuries
- Orthopedic conditions
🇨🇦 Approved in Canada as Virtual Physical Therapy for:
- Ankle sprains
- Musculoskeletal injuries
- Orthopedic conditions
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
University of KentuckyLexington, KY
Loading ...
Who Is Running the Clinical Trial?
Kyle KosikLead Sponsor
References
Use of real-time videoconferencing to deliver physical therapy services: A scoping review of published and emerging evidence. [2021]Telehealth may be a viable means to deliver physical therapy services across a range of practice settings and health conditions; however, there is limited uptake of telehealth in clinical practice. The purpose of this study is to examine and describe trends, gaps and opportunities in published and emerging evidence regarding the use of real-time videoconferencing to deliver physical therapy services.
Efficacy of Telehealth for Movement-Evoked Pain in People With Chronic Achilles Tendinopathy: A Noninferiority Analysis. [2023]The purpose of this study was to compare the efficacy of physical therapy delivered via an all telehealth or hybrid format with an all in-person format on movement-evoked pain for individuals with chronic Achilles tendinopathy (AT).
Telemedicine for Musculoskeletal Rehabilitation and Orthopedic Postoperative Rehabilitation. [2021]Telehealth visits result in high-quality care, with high patient and provider satisfaction. Strong evidence suggests that virtual physical therapy is noninferior to conventional face-to-face physical therapy for a variety of musculoskeletal disorders. Postoperative telerehabilitation has a strong positive effect on clinical outcomes, and the increased intensity telerehabilitation programs offer is a promising option for patients. Studies demonstrate effective virtual postoperative management. The novel coronavirus disease 2019 pandemic has led to improved reimbursement for telehealth visits and accelerated widespread implementation of telemedicine. This article establishes experience and evidence-based practice guidelines for conducting telemedicine visits, with emphasis on the virtual physical examination.
A Physical Therapist's Role in Clinical Video Telehealth. [2023]Telehealth sessions including a physical therapist have been implemented for physical examinations, shared diabetes appointments, and obesity and weight management classes.
Virtual Physical Therapy and Telerehabilitation. [2021]Telerehabilitation is now a mainstay in health care delivery, with recent trends pointed to continued expansion in the future. Physical therapy (PT) being provided via telehealth, also known as virtual PT, has been demonstrated to provide functional improvements and satisfaction for the consumer and provider, and is applicable in various physical therapy treatment diagnostic areas. Research and technology enhancements will continue to offer new and innovative means to provide physical therapy. This article further provides points to make virtual PT successful and highlights some recommended equipment and outcome recommendations. The future is bright for providing virtual PT.
Low-bandwidth, Internet-based videoconferencing for physical rehabilitation consultations. [2022]Low-bandwidth, Internet-based videoconferencing was used to provide physical rehabilitation consultation services for eight community hospitals. Videoconferencing and file transmission used a PC and modem. A separate telephone line was used for voice. Over 21 months, 47 physical rehabilitation consultations were completed for communication disorders, foot care, gait problems, orthotics, prosthetics, arm weakness and wheelchair prescription. Consultations were approximately 40 min long. Clinician questionnaires were completed by 47 individuals. While more than 80% of the questionnaire responses supported the telemedicine approach, remote clinicians rated their satisfaction higher than did the specialists. Client questionnaires were completed by 24 individuals (a response rate of 51%). All clients were comfortable with and had confidence in the teleconsultations.
COVID-19 Lessons From The Field: Toward A Pediatric Physical Therapy Telehealth Framework. [2022]Telehealth is an established health service delivery method, yet little is known regarding pediatric physical therapy telehealth. We aimed to evaluate users' experiences and create a framework for effective delivery.
Vestibular Rehabilitation Telehealth During the SAEA-CoV-2 (COVID-19) Pandemic. [2022]During the COVID-19 pandemic, physical therapists transitioned to provide telehealth in the United States. We sought to determine the experiences of physical therapists delivering telerehabilitation for vestibular disorders including barriers, preferences, and concerns. A survey was created using the results of a focus group and previously published studies. The survey was distributed across social media sites and through email- the link was sent to the orthopedic, neurologic, and geriatric academies of the American Physical Therapy Association list serves. The email was also shared with each of the 50 state chapters of the American Physical Therapy Association. The survey was broken down into five sections: demographic information, physical therapists' general impressions of telehealth, physical therapists' comfort level treating various vestibular diagnoses, and common barriers physical therapists experienced during telehealth sessions. There were 159 completed surveys. More than 80% of physical therapists surveyed agreed that telehealth was an effective platform for vestibular physical therapy. When asked whether physical therapists felt the patient had similar health outcomes with telehealth versus clinic care 68% of physical therapists agreed. For the physical therapists who treated posterior or horizontal canal benign paroxysmal positional vertigo via telehealth, more than 50% were comfortable treating these conditions via telehealth. In analyzing common peripheral vestibular diagnoses treated via telehealth including bilateral vestibular loss, Meniere's disease, and vestibular neuritis more than 75% of the physical therapists reported comfort treating these diagnoses. Similarly, more than 75% of physical therapists who treated central vestibular diagnoses- including mild traumatic brain injury and vestibular migraine- via telehealth reported being comfortable treating these diagnoses. Physical therapists reported several barriers to tele healthcare ranging from concerns about testing balance with no caregiver present (94%) to challenges with providing a written home exercise program (33%). Physical therapists report that telehealth is a viable mechanism for providing rehabilitation for persons with balance and vestibular disorders. For common diagnoses, most physical therapists were comfortable treating vestibular disorders via telehealth. While barriers remain including maintaining patient safety and being able to complete a thorough vestibular exam, telehealth for vestibular physical therapy services holds promise for the delivery of virtual care.
Telerehabilitation consultations for clients with neurologic diagnoses: cases from rural Minnesota and American Samoa. [2019]Telerehabilitation is the provision of rehabilitation services at a distance using electronic information and communication technologies. This paper describes two clinical programs that utilize videoconferencing to provide rehabilitation specialist consultations to individuals living in remote areas. Needs assessments for the two areas revealed that local clinicians were interested in access to specialty consultation. Administrative processes and a data collection tool were developed for these programs. High speed videoconferencing that allows for real-time audio and video interaction was used. Each consultation includes the patient, the local caregivers and specialists from our facilities interacting via videoconferencing. A total of 117 telerehabilitation encounters have been completed. All consultations resulted in changes to the plan of care. Clinicians who participated in the projects consistently rated the clinical effectiveness of teleconsults as good or excellent. Thirty-eight consultations have been neurologic in nature. Of that set, 25 of the visits were initial assessments, and thirteen were follow-up visits. Two case studies of individuals with neurologic diagnoses are presented. Recommendations to others who are providing rehabilitation services via telehealth technologies are included. The authors conclude that the care of individuals with neurologic issues can be augmented and supported via specialty consultation using telehealth technology.
The Virtual Foot and Ankle Physical Examination. [2020]The COVID-19 pandemic has necessitated a rapid and drastic shift for clinicians and patients away from traditional in-person visits and toward internet-based virtual visits. The adoption of telehealth services is likely to persist in some capacity even as in-person visits resume, given the convenience and efficiency of telehealth consultations for patients and perhaps surgeons. A primary challenge of virtual visits, particularly in the field of orthopedic surgery, is the physical examination. However, for the foot and ankle, routine physical examination maneuvers can be completed virtually with little modification given proper patient instruction. We present a comprehensive virtual foot and ankle examination for telehealth visits, including instructions that can be provided to patients verbatim and a corresponding checklist for provider documentation.Level of Evidence: Level V, expert opinion.
Effectiveness of telerehabilitation in physical therapy: A protocol for an overview in a time when rapid responses are needed. [2022]Rehabilitation and physical therapy have been adapting to the telehealth era, increasing accessibility and improving the continuity of attention in geographically remote populations with disabilities. Due to the spread of infection by SARS-CoV-2, many professionals have had to adapt their work to telerehabilitation practices, which require the best evidence at short notice and in summarized form. In this context, this protocol has been developed to evaluate the effectiveness of telerehabilitation as a care strategy in physical therapy for different conditions, populations, and contexts.