Skip to main content

Advertisement

SpringerLink
Log in

Evaluating Effectiveness of Telerehabilitation Services Among Injured Workers Treated in a Canadian Workers’ Compensation System: A Population-Based Study

  • Published:
Journal of Occupational Rehabilitation Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the effectiveness of telerehabilitation for promoting return-to-work (RTW) among injured workers.

Methods

We conducted a pragmatic, quasi-experimental study comparing telerehabilitation, in-person, or hybrid services. Descriptive statistics analyzed demographics, occupational factors, and patient-reported outcome measures (PROMs). Kruskal–Wallis tests investigated differences between mode of delivery and changes in PROM scores. Logistic and Cox-proportional hazard regression examined associations between mode of delivery and RTW status or days receiving wage replacement benefits in the first-year post-discharge, respectively, while controlling for potential confounders.

Results

A slightly higher percentage of the 3,708 worker sample were male (52.8%). Mean (standard deviation (SD)) age across all delivery formats was 45.5 (12.5) years. Edmonton zone had the highest amount of telerehabilitation delivery (53.5%). The majority of workers had their program delivered in a hybrid format (54.1%) and returned to work (74.4%) at discharge. All PROMs showed improvement although differences across delivery formats were not clinically meaningful. Delivery via telerehabilitation had significantly lower odds of RTW at discharge (Odds Ratio: 0.82, 95% Confidence Interval: 0.70–0.97) and a significantly lower risk of experiencing suspension of wage replacement benefits in the first year following discharge (Hazard Ratio: 0.92, 95% Confidence Interval: 0.84–0.99). Associations were no longer significant when confounders were controlled for.

Conclusion

RTW outcomes were not statistically different across delivery formats, suggesting that telerehabilitation is a novel strategy that may improve equitable access and earlier engagement in occupational rehabilitation. Factors such as gender and geographic location should be considered when deciding on service delivery format.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data Availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Policy Reseach Division SPD., Population and public health branch, health Canada. Economic burden of illness in Canada, 1998. 2002.

  2. Canada Go. Coronavirus disease (COVID-19): Government of Canada. ; 2023 [updated 2023-08-04. Available from: https://www.canada.ca/en/public-health/services/diseases/coronavirus-disease-covid-19.html.

  3. Landry MD, Tupetz A, Jalovcic D, Sheppard P, Jesus TS, Raman SR. The novel coronavirus (COVID-19): making a connection between infectious disease outbreaks and rehabilitation. Physiother Can. 2020;72(4):325–327.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Gross DP, Asante A, Pawluk J, Niemelainen R. A descriptive study of the implementation of remote occupational rehabilitation services due to the COVID-19 pandemic within a workers’ compensation context. J Occup Rehabil. 2021;31(2):444–453.

    Article  PubMed  Google Scholar 

  5. Asante AK, Brintnell ES, Gross DP. Functional self-efficacy beliefs influence functional capacity evaluation. J Occup Rehabil. 2007;17(1):73–82.

    Article  PubMed  Google Scholar 

  6. Gross DP, Asante AK, Miciak M, Battie MC, Carroll LJ, Sun A, et al. Are performance-based functional assessments superior to semistructured interviews for enhancing return-to-work outcomes? Arch Phys Med Rehabil. 2014;95(5):807-815.e1.

    Article  PubMed  Google Scholar 

  7. Gross DP, Asante AK, Miciak M, Battie MC, Carroll LJ, Sun A, et al. A cluster randomized clinical trial comparing functional capacity evaluation and functional interviewing as components of occupational rehabilitation programs. J Occup Rehabil. 2014;24(4):617–630.

    Article  PubMed  Google Scholar 

  8. Gross DP, Park J, Rayani F, Norris CM, Esmail S. Motivational interviewing improves sustainable return to work in Injured workers after Rehabilitation: a Cluster Randomized Controlled Trial. Arch Phys Med Rehabil. 2017;98(12):2355–2363.

    Article  PubMed  Google Scholar 

  9. Park J, Esmail S, Rayani F, Norris CM, Gross DP. Motivational interviewing for workers with disabling musculoskeletal disorders: results of a cluster randomized control trial. J Occup Rehabil. 2018;28(2):252–264.

    Article  PubMed  Google Scholar 

  10. Merali Z, Wilson JR. Explanatory versus pragmatic trials: an essential concept in study design and interpretation. Clin Spine Surg. 2017;30(9):404–406.

    Article  PubMed  Google Scholar 

  11. Schweizer ML, Braun BI, Milstone AM. Research methods in healthcare epidemiology and antimicrobial stewardship-quasi-experimental designs. Infect Control Hosp Epidemiol. 2016;37(10):1135–1140.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). Med Care. 1992;30(6):473–483.

    Article  PubMed  Google Scholar 

  13. Tait RC, Chibnall JT, Karause S. The Pain Disability Index: psychometric properties. Pain. 1990;40:171–182.

    Article  PubMed  Google Scholar 

  14. Myles PS, Troedel S, Boquest M, Reeves M. The pain visual analogue scale: is it linear or nonlinear? Anesth Analg. 1999;89:1517–1520.

    Article  CAS  PubMed  Google Scholar 

  15. Linton S, Halldén K. Can we screen for problematic back pain? a screening questionnaire for predicting outcome in acute and subacute back pain. Clin J Pain. 1998;14(3):209–215.

    Article  CAS  PubMed  Google Scholar 

  16. Binkley JM, Stratford PW, Lott S, Riddle DL. The Lower Extremity Functional Scale (LEFS): scale development, measurement properties, and clinical application. Phys Ther. 1999;79(4):371–383.

    CAS  PubMed  Google Scholar 

  17. Hosmer D, Lemeshow S, May S. Applied survival analysis. Second. Hoboken: Wiley; 2008.

    Book  Google Scholar 

  18. Hosmer D, Lemeshow S, Sturdivant R. Applied logistic regression. Third. Hoboken: Wiley; 2013.

    Book  Google Scholar 

  19. Cottrell MA, Galea OA, O’Leary SP, Hill AJ, Russell TG. Real-time telerehabilitation for the treatment of musculoskeletal conditions is effective and comparable to standard practice: a systematic review and meta-analysis. Clin Rehabil. 2017;31(5):625–638.

    Article  PubMed  Google Scholar 

  20. Krzyzaniak N, Cardona M, Peiris R, Michaleff ZA, Greenwood H, Clark J. Telerehabilitation versus face-to-face rehabilitation in the management of musculoskeletal conditions: a systematic review and meta-analysis. Phys Ther Rev. 2023;28(2):71–87.

    Article  Google Scholar 

  21. Cui D, Janela D, Costa F, Molinos M, Areias AC, Moulder RG, et al. Randomized-controlled trial assessing a digital care program versus conventional physiotherapy for chronic low back pain. NPJ Digit Med. 2023;6(1):121. https://doi.org/10.1038/s41746-023-00870-3.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Ebbert JO, Ramar P, Tulledge-Scheitel SM, Njeru JW, Rosedahl JK, Roellinger D, et al. Patient preferences for telehealth services in a large multidisciplinary practice. J Telemed Telecare. 2023;29(4):298–303.

    Article  PubMed  Google Scholar 

  23. Polinski JM, Barker T, Gagliano N, Sussman A, Brennan TA, Shrank WH. Patients’ satisfaction with and preference for telehealth visits. J Gen Intern Med. 2015;31:269–275.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Barton CJ, Ezzat AM, Bell EC, Rathleff MS, Kemp JL, Crossley KM. Knowledge, confidence and learning needs of physiotherapists treating persistent knee pain in Australia and Canada: a mixed-methods study. Physiother Theory Pract. 2022;38(12):2073–2085.

    Article  PubMed  Google Scholar 

  25. Fernandes LG, Devan H, Fioratti I, Kamper SJ, Williams CM, Saragiotto BT. At my own pace, space, and place: a systematic review of qualitative studies of enablers and barriers to telehealth interventions for people with chronic pain. Pain. 2022;163(2):e165–181.

    Article  PubMed  Google Scholar 

  26. Imlach F, McKinlay E, Middleton L, Kennedy J, Pledger M, Russell L, et al. Telehealth consultations in general practice during a pandemic lockdown: survey and interviews on patient experiences and preferences. BMC Fam Pract. 2020;21(1):1–14.

    Article  Google Scholar 

  27. Haleem A, Javaid M, Singh RP, Suman R. Telemedicine for healthcare: capabilities, features, barriers, and applications. Sens Int. 2021;2:100117. https://doi.org/10.1016/j.sintl.2021.100117.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Cottrell MA, Russell TG. Telehealth for musculoskeletal physiotherapy. Musculoskelet Sci Pract. 2020;48:102193. https://doi.org/10.1016/j.msksp.2020.102193.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Flynn A, Preston E, Dennis S, Canning CG, Allen NE. Utilising telehealth to support exercise and physical activity in people with Parkinson Disease: a program evaluation using mixed methods. BMC Health Serv Res. 2023;23(1):1–12.

    Article  Google Scholar 

Download references

Acknowledgements

We would like to acknowledge that this project won best WDPI Student Researcher Award at the PREMUS, WDPI, and MYOPAIN 2023 conference in Bengaluru, India. Dr. Ming Ye provided statistical consultation.

Funding

This work was supported by the 2022 WCB-Alberta Research Grants Competition [RES0058588].

Author information

Authors and Affiliations

  1. Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada

    Katelyn Brehon, Gagan Nagra, Maxi Miciak & Douglas P. Gross

  2. Workers’ Compensation Board of Alberta, Edmonton, Canada

    Riikka Niemeläinen

Authors
  1. Katelyn Brehon
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gagan Nagra
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Maxi Miciak
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Riikka Niemeläinen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Douglas P. Gross
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the study conception and design. Data cleaning and analysis were performed by KB. The first draft of the manuscript was written by KB with assistance from GN. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Katelyn Brehon.

Ethics declarations

Competing Interests

The authors have no relevant financial or non-financial interests to disclose.

Ethical Approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the University of Alberta Health Research Ethics Committee (Pro00120406).

Consent to Participate

A waiver of consent was obtained prior to data retrieval and analysis.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 14.0 kb)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Brehon, K., Nagra, G., Miciak, M. et al. Evaluating Effectiveness of Telerehabilitation Services Among Injured Workers Treated in a Canadian Workers’ Compensation System: A Population-Based Study. J Occup Rehabil (2024). https://doi.org/10.1007/s10926-023-10165-9

Download citation

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s10926-023-10165-9

Keywords

Search

Navigation