Retrospective Case-Control Study on the Effect of In-Person Physical Therapy With Remote Therapeutic Monitoring on Functional Outcomes and Plan of Care Adherence Amongst Individuals With Musculoskeletal Conditions

Objective: To evaluate the efficacy of in-person physical therapy (PT) coupled with remote therapeutic monitoring (RTM) compared to in-person PT only on patient outcomes and care delivery. Design: A case-control study Setting: 95 private practice physical therapy clinics. RTM is delivered at home via a mobile application. Participants: Inclusion criteria included: (1) Adults ≥18 years of age, (2) musculoskeletal diagnosis, (3) clinician-prescribed PT, (4) at least 2 outcome measures. Patients who met the inclusion criteria were enrolled in RTM. A control group was generated using 3:1 matching based on: age, sex, case type, and intake patient-reported outcome score. Three hundred and six cases for the in-person PT + RTM group (N = 306) and 918 (N = 918) controls were identified. Interventions: RTM Patients were enrolled in a home exercise program administered through a mobile application, with digital exercise therapy videos and care navigation support. Both RTM and control patients were enrolled in in-person PT. Main Outcome Measures: Achieving the discharge functional status score as measured by the binary yes/no Functional Status Benchmark. Results: A significantly greater proportion of PT + RTM patients achieved the Functional Statue Benchmark (72%) compared to the control group (63%, P=.004). A statistically greater proportion of PT + RTM patients attended more than 2 visits per week (36%) compared to the control group (24%, P<.001). When controlling all variables, RTM participation was a significant predictor of achieving the discharge functional status score as measured by the binary yes/no Functional Status Benchmark (adjusted odds ratio, 1.53; 95% confidence interval, 1.04-2.22). Conclusions: The inclusion of RTM with in-person PT facilitated better patient engagement and patient-reported outcomes compared to in-person PT only.