Opinion on the effectiveness of physiotherapy management of neuro-musculo-skeletal disorders by telerehabilitation
Résumé
In this period of containment related to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), the objective of this article is to formulate an opinion on the effectiveness of physiotherapy management of Neuromusculoskeletal Disorders (NMSD) by telerehabilitation (TR) as well as guidelines for physiotherapists. The effectiveness of TR physiotherapy management will be
evaluated based on the results published in the scientific literature regarding disability, pain, sense of self-management and health-related quality of life. Particular attention will be paid to the Belgian and French contexts, although the validity of the bibliographical synthesis presented is more wide-ranging. From a technical point of view, the material necessary to practice TR is already available to a large majority of Belgian and French citizens. Assessment in TR physiotherapy is technically feasible for various NMSD with good validity and excellent reliability for many variables. Even if the most basic technological
modality for TR is the telephone interview, in the context of contemporary and efficient physiotherapy practice, we rather advocate the use of video, both in a synchronous and asynchronous delivery, which allows sharing physical exercises
with patients through numerous applications available on the internet. TR physiotherapy helps maintain the compliance of patients with NMSD in the upper and lower limbs to the exercises as well as their motivation. Strong evidence for effectiveness of synchronous and asynchronous TR after orthopaedic knee or hip surgery is available in the literature. For low back pain, positive results have been observed in patients with both acute and chronic conditions. Within the framework of the Interreg FWVl NOMADe project, and despite certain methodological limitations related to our literature search and the urgency to formulate an opinion before the end of the SARS-CoV-2 containment, we conclude that during the containment period TR is feasible and even desirable for patients suffering from NMSD affecting both the upper and lower quadrants. We have no doubt that the practice of TR physiotherapy on the French and Belgian slopes will allow patients suffering from NMSD to benefit from quality physiotherapy care, both during the confinement period and as a complement to the usual face-to-face care when deconfinement will take place. There is no doubt that TR has a bright future in Europe and the rest of the world