Telemed J E Health - The validity of physical therapy assessment of low back pain via telerehabilitation in a clinical setting.

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Resumo

CKGROUND: Back pain is a common and disabling condition for people in rural and remote areas. In these areas, access to rehabilitation services is limited by service availability. Telerehabilitation is suggested as a solution for providing physical therapy services; however, the validity of clinical assessment is largely unproven. The aim of this study was to establish the validity of clinically pragmatic remote assessment of spinal posture, active movements of the lumbar spine, and the passive straight leg raise (SLR) test.SUBJECTS AND METHODS: Face-to-face physical therapist assessment was compared with telerehabilitation assessment of spinal posture, active movements of the lumbar spine, and the SLR test. Twenty-six participants recruited from a rural population with current or recent low back pain (LBP) were assessed by a face-to-face physical therapist and a remote physical therapist. Pain, disability, and clinical measurements were assessed. Outcomes were compared to establish agreement.RESULTS: High levels of agreement were found with detecting pain with specific lumbar movements, eliciting symptoms, and sensitizing the SLR test. Moderate agreement occurred with identifying the worst lumbar spine movement direction, SLR range of motion, and active lumbar spine range of motion. Poor agreement occurred with postural analysis and identifying reasons for limitations to lumbar movements.CONCLUSIONS: Conducted in a rural clinical setting, this study validates elements of the physical assessment of the lumbar spine and identifies technical and clinical issues to be addressed by future research. Important components of the standard musculoskeletal assessment of LBP are valid via telerehabilitation in a clinical setting.

Resumo Limpo

ckground back pain common disabl condit peopl rural remot area area access rehabilit servic limit servic avail telerehabilit suggest solut provid physic therapi servic howev valid clinic assess larg unproven aim studi establish valid clinic pragmat remot assess spinal postur activ movement lumbar spine passiv straight leg rais slr testsubject method facetofac physic therapist assess compar telerehabilit assess spinal postur activ movement lumbar spine slr test twentysix particip recruit rural popul current recent low back pain lbp assess facetofac physic therapist remot physic therapist pain disabl clinic measur assess outcom compar establish agreementresult high level agreement found detect pain specif lumbar movement elicit symptom sensit slr test moder agreement occur identifi worst lumbar spine movement direct slr rang motion activ lumbar spine rang motion poor agreement occur postur analysi identifi reason limit lumbar movementsconclus conduct rural clinic set studi valid element physic assess lumbar spine identifi technic clinic issu address futur research import compon standard musculoskelet assess lbp valid via telerehabilit clinic set

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