Increased Utilization of Remote Monitoring Physical Therapy for Upper Limb Rehabilitation in Disadvantaged Groups...

Remote monitoring physical therapy (RMPT) is an innovative and effective solution for postoperative rehabilitation in orthopaedic care. However, its ability to increase access particularly in socioeconomically disadvantaged communities is yet to be fully explored. This study investigates the association between RMPT utilization and socioeconomic disadvantage, as measured by the Area Deprivation Index (ADI), in patients undergoing upper extremity orthopaedic rehabilitation.

Patients from more socioeconomically disadvantaged neighborhoods, represented by higher ADI quartiles, would demonstrate increased utilization and compliance with RMPT compared with those in lower ADI quartiles.

Case series; Level of evidence, 4.

A retrospective review was conducted on the records of 875 patients receiving upper extremity RMPT from January 2022 to January 2024 across 8 institutions. Patients were divided into 4 quartiles based on ADI scores. Data collection included demographics, number of completed sessions/exercises, and duration of RMPT. Analysis of variance and the Tukey honestly significant difference test were performed for continuous variables using RStudio with a P value <.05 considered significant for comparisons.

A total of 875 patients with a mean age of 59.3 ± 11.4 years and a mean rehabilitation duration of 22.8 ± 10.7 weeks were included in the analysis. Among them, 785 (90%) underwent RMPT for shoulder conditions, 73 (8%) for hand conditions, and 17 (2%) for elbow conditions. Patients in the highest ADI quartile had significantly longer treatment durations (mean, 25.5 ± 14.2 weeks) and completed more sessions (mean, 62.2 ± 74.9) compared with those in the lowest quartile (mean, 20.7 ± 7.9 weeks; mean, 33.4 ± 47.9 sessions; P < .001). A statistically significant difference was noted when comparing the change in visual analog scale (VAS) pain score (P = .04) across the ADI quartiles (19%-20% change ≥4 points in Q1-Q3; P = .019). Despite these differences, there were no significant differences in exercise compliance (P = .313) or session compliance (P = .416).

This study found that patients from socioeconomically disadvantaged areas, as measured by the ADI, utilized RMPT more extensively compared with patients from less disadvantaged areas. However, compliance across sessions and exercises was consistent across all ADI groups. RMPT shows potential for improving access to physical therapy among disadvantaged populations, although further research is needed to evaluate the clinical effect of these findings.