ArborTelehealth

Why are we conducting this study?

Low back pain is a major problem in the United States and the rest of the world. A few important facts about low back pain:

  1. Low back pain is the top cause of disability globally, including the United States.
  2. Low back is the most expensive health condition in the United States, accounting for over $135 billion in spending per year.
  3. Low back is the most common reason that opioids are prescribed and used in the United States

Physical therapy is an effective treatment for patients with low back pain. Delivered by a physical therapist, physical therapy focuses on the use of exercise and education to help improve symptoms associated with low back pain. Previous studies have shown that patients with low back pain who receive physical therapy report decreased pain and disability, as well as improved physical function. Studies have also shown that patients who receive physical therapy fore their low back pain are less likely to use opioids to treat their pain.

Unfortunately, physical therapy is often less accessible for patients living in rural parts of the country. Studies have shown that there are fewer physical therapists available in rural parts of the country compared to more urban areas. In addition, rural communities often span large geographic areas, meaning that patients need to travel farther to attend physical therapy. This might also mean that they need to miss extra time from work or find help for child or elderly care.

Telehealth stands to improve access to physical therapy for patients with low back pain living in rural communities. During the COVID-19 pandemic, a number of policy changes were made that allowed many physical therapists to provide care using telehealth visits for the first time. These changes have the potential to greatly improve access to physical therapy for patients who are not able to receive care in-person for any reason. However, telehealth physical therapy is relatively new and there is a lack of research examining how well this approach works.

We are conducting this study to examine the effects of telehealth physical therapy among patients with low back pain living in rural Maryland. This study will be one of the first studies conducted examining the use of telehealth physical therapy for patients with low back pain. The results of the study will provide important information on how telehealth physical therapy effects pain, disability, and use of other health care services.

Study Overview

Study Design

This study is being conductedhrough a partnership between TidalHealth and Johns Hopkins University.

We will enroll individuals with chronic low back pain receiving care from a primary care provider at TidalHealth. Enrolled participants will be randomly assigned to receive telehealth physical therapy or standardized education.

The standardized education intervention includes research-based educational information designed for patients experiencing low back pain.

Patients randomized to the telehealth physical therapy group will receive 8 weekly telehealth visits with a TidalHealth physical therapist.

Outcomes

All patients will be contacted 8 weeks, 4 months, and 12 months after study enrollment to complete questionnaires that will allow our team to examine the effects of educational interventions and telehealth physical therapy.

We will use a combination of surveys and data from the electronic medical record to measure the following key outcomes: