Remote Musculoskeletal Assessment Framework: A Guide for Primary Care

Primary care clinicians face challenges adapting musculoskeletal (MSK) assessments to remote settings. MSK conditions account for a significant portion of primary care consultations, but traditional methods require in-person exams. The shift to virtual care during the pandemic exposed a gap in guidance for remote MSK evaluation. Prior research has shown the feasibility of teleconsultations in physiotherapy and rehabilitation, but no evidence exists for primary care. This paper addresses the lack of practical, evidence-based frameworks for remote MSK assessment. The absence of standardized protocols in primary care settings limits the quality of virtual consultations. This gap motivated the development of a systematic literature review to identify and adapt existing MSK examination techniques for remote use. The goal is to maintain diagnostic accuracy while reducing infection risks in clinical workflows. This study builds on prior work in telemedicine and adapts it to primary care needs.

The study aimed to develop a practical framework for remote MSK assessment in primary care. With the rise of teleconsultations due to the pandemic, clinicians needed guidance to maintain diagnostic quality. The specific problem was the lack of evidence-based protocols for remote MSK exams. The motivation was to ensure continuity of care while minimizing infection risks. The study focused on adapting existing MSK examination techniques for virtual settings. It also aimed to fill the gap in primary care-specific telemedicine guidance. The framework needed to be accessible and easy to implement in clinical practice. The goal was to provide a ready-to-use resource for primary care clinicians.

The researchers conducted a systematic literature review to identify relevant evidence. They searched for published studies and guidelines on MSK teleconsultations. Over 2232 papers were initially identified, narrowing down to 28 relevant sources. No primary care-specific evidence was found for MSK remote assessments. The team adapted established examination techniques for virtual use where evidence was lacking. Modified tests were developed from traditional face-to-face methods. A step-by-step framework was created for remote MSK evaluation. The framework included pre-consultation guidance and examination instructions.

The literature review revealed no primary care-specific evidence for MSK teleconsultations. However, physiotherapy and rehabilitation studies supported the feasibility of remote MSK exams. The team developed a framework using adapted and modified examination techniques. The framework includes pre-consultation guidance and detailed examination steps. Patient and clinician resources were created to support the framework. These included a patient information leaflet and photographic examples. The framework was tested on a non-medically trained volunteer for usability. The final product is a downloadable, ready-to-use guide for primary care clinicians.

The study synthesized evidence to create a practical framework for remote MSK assessment. The authors propose that this framework fills a critical gap in primary care telemedicine. They suggest that the 'look, point, move' system improves diagnostic accuracy in virtual settings. The framework includes modified special tests for remote use. The authors emphasize the need for standardized protocols in primary care. They propose that the framework maintains diagnostic quality while reducing infection risks. The study concludes that the framework is a ready-to-use resource for clinicians. The authors suggest that this approach supports continuity of care during the pandemic.