Evaluating Effectiveness of Telerehabilitation Among Workers Admitted to a Posttraumatic Stress Injury Rehabilitation Program

Overview

Journal J Occup Rehabil

Publisher Springer

Specialties Occupational Medicine
Rehabilitation Medicine

Date 2025 Mar 11

PMID 40064793

Authors

Brandon K Krebs

Katelyn Brehon

Maxi Miciak

Bruce D Dick

Suzette C Bremault-Phillips

Sebastian Straube

Douglas P Gross

Affiliations

Soon will be listed here.

Abstract

Purpose: Telerehabilitation or hybrid delivery (i.e., a mixture of telerehabilitation and in-person care) was increasingly used to deliver posttraumatic stress injury (PTSI) rehabilitation in response to the COVID-19 pandemic. Limited research, however, has evaluated the use of telerehabilitation to deliver PTSI interventions, including exposure-based therapies, and some service providers concerned about the potential adverse effects of delivery over telerehabilitation continue to advocate for in-person delivery. We evaluated the effectiveness of telerehabilitation versus hybrid delivery in promoting return-to-work (RTW) among workers with PTSI.

Methods: We conducted a pragmatic, quasi-experimental study using archived data from workers undergoing PTSI rehabilitation programs offered by the Workers' Compensation Board of Alberta. The RTW outcomes of workers treated solely using telerehabilitation between November 6, 2020, and September 30, 2021, were compared to outcomes of workers treated using a hybrid model of delivery. A logistic regression analysis was used to examine if the method of treatment delivery was associated with RTW outcomes while controlling for a variety of potential confounders.

Results: The study cohort included 222 workers with ongoing workers' compensation claims for PTSI. The majority were middle-aged (mean 42 years) men (61%) working as public safety personnel (35.9%) or in transport occupations (25.2%). The adjusted regression model showed no statistically significant differences in RTW outcomes between workers receiving telerehabilitation or hybrid treatment (Adjusted Odds Ratio 1.7; 95% CI 0.8-3.6).

Conclusion: PTSI rehabilitation programs delivered exclusively via virtual means appear to produce RTW outcomes that are equally effective to delivery using a hybrid model.

References

Lee W, Lee Y, Yoon J, Lee H, Kang M . Occupational post-traumatic stress disorder: an updated systematic review. BMC Public Health. 2020; 20(1):768. PMC: 7245752. DOI: 10.1186/s12889-020-08903-2. View

Landry M, Tupetz A, Jalovcic D, Sheppard P, Jesus T, Raman S . The Novel Coronavirus (COVID-19): Making a Connection between Infectious Disease Outbreaks and Rehabilitation. Physiother Can. 2022; 72(4):325-327. PMC: 8781500. DOI: 10.3138/ptc-2020-0019. View

Gross D, 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. 2020; 31(2):444-453. PMC: 7592640. DOI: 10.1007/s10926-020-09934-7. View

Jones C, Miguel-Cruz A, Smith-MacDonald L, Cruikshank E, Baghoori D, Kaur Chohan A . Virtual Trauma-Focused Therapy for Military Members, Veterans, and Public Safety Personnel With Posttraumatic Stress Injury: Systematic Scoping Review. JMIR Mhealth Uhealth. 2020; 8(9):e22079. PMC: 7536597. DOI: 10.2196/22079. View

Foa E, Gillihan S, Bryant R . Challenges and Successes in Dissemination of Evidence-Based Treatments for Posttraumatic Stress: Lessons Learned From Prolonged Exposure Therapy for PTSD. Psychol Sci Public Interest. 2015; 14(2):65-111. PMC: 4338436. DOI: 10.1177/1529100612468841. View

Brehon K, Nagra G, Miciak M, Niemelainen R, Gross D . Evaluating Effectiveness of Telerehabilitation Services Among Injured Workers Treated in a Canadian Workers' Compensation System: A Population-Based Study. J Occup Rehabil. 2024; 34(4):793-802. DOI: 10.1007/s10926-023-10165-9. View

Fernandez E, Woldgabreal Y, Day A, Pham T, Gleich B, Aboujaoude E . Live psychotherapy by video versus in-person: A meta-analysis of efficacy and its relationship to types and targets of treatment. Clin Psychol Psychother. 2021; 28(6):1535-1549. DOI: 10.1002/cpp.2594. View

Gava V, Ribeiro L, Py Goncalves Barreto R, Camargo P . Effectiveness of physical therapy given by telerehabilitation on pain and disability of individuals with shoulder pain: A systematic review. Clin Rehabil. 2022; 36(6):715-725. DOI: 10.1177/02692155221083496. View

Hinman R, Campbell P, Kimp A, Russell T, Foster N, Kasza J . Telerehabilitation consultations with a physiotherapist for chronic knee pain versus in-person consultations in Australia: the PEAK non-inferiority randomised controlled trial. Lancet. 2024; 403(10433):1267-1278. DOI: 10.1016/S0140-6736(23)02630-2. View

10.

Nelson M, Russell T, Crossley K, Bourke M, McPhail S . Cost-effectiveness of telerehabilitation versus traditional care after total hip replacement: A trial-based economic evaluation. J Telemed Telecare. 2019; 27(6):359-366. DOI: 10.1177/1357633X19869796. View

11.

Molina-Garcia P, Mora-Traverso M, Prieto-Moreno R, Diaz-Vasquez A, Antony B, Ariza-Vega P . Effectiveness and cost-effectiveness of telerehabilitation for musculoskeletal disorders: A systematic review and meta-analysis. Ann Phys Rehabil Med. 2023; 67(1):101791. DOI: 10.1016/j.rehab.2023.101791. View

12.

Peretti A, Amenta F, Tayebati S, Nittari G, Mahdi S . Telerehabilitation: Review of the State-of-the-Art and Areas of Application. JMIR Rehabil Assist Technol. 2017; 4(2):e7. PMC: 5544892. DOI: 10.2196/rehab.7511. View

13.

Wells S, Morland L, Wilhite E, Grubbs K, Rauch S, Acierno R . Delivering Prolonged Exposure Therapy via Videoconferencing During the COVID-19 Pandemic: An Overview of the Research and Special Considerations for Providers. J Trauma Stress. 2020; 33(4):380-390. PMC: 7461321. DOI: 10.1002/jts.22573. View

14.

Brehon K, Niemelainen R, Hall M, Bostick G, Brown C, Wieler M . Return-to-Work Following Occupational Rehabilitation for Long COVID: Descriptive Cohort Study. JMIR Rehabil Assist Technol. 2022; 9(3):e39883. PMC: 9484483. DOI: 10.2196/39883. View

15.

Gross D, Rachor G, Yamamoto S, Dick B, Brown C, Senthilselvan A . Characteristics and Prognostic Factors for Return to Work in Public Safety Personnel with Work-Related Posttraumatic Stress Injury Undergoing Rehabilitation. J Occup Rehabil. 2021; 31(4):768-784. DOI: 10.1007/s10926-021-09963-w. View

16.

Rose J . A model of care for managing traumatic psychological injury in a workers' compensation context. J Trauma Stress. 2006; 19(3):315-26. DOI: 10.1002/jts.20126. View

17.

Clay F, Berecki-Gisolf J, Collie A . How well do we report on compensation systems in studies of return to work: a systematic review. J Occup Rehabil. 2013; 24(1):111-24. DOI: 10.1007/s10926-013-9435-z. View

18.

Cottrell M, Galea O, OLeary S, Hill A, Russell T . Real-time telerehabilitation for the treatment of musculoskeletal conditions is effective and comparable to standard practice: a systematic review and meta-analysis. Clin Rehabil. 2016; 31(5):625-638. DOI: 10.1177/0269215516645148. View

19.

Hung Kn G, Fong K . Effects of telerehabilitation in occupational therapy practice: A systematic review. Hong Kong J Occup Ther. 2019; 32(1):3-21. PMC: 6560836. DOI: 10.1177/1569186119849119. View

20.

Levesque J, Harris M, Russell G . Patient-centred access to health care: conceptualising access at the interface of health systems and populations. Int J Equity Health. 2013; 12:18. PMC: 3610159. DOI: 10.1186/1475-9276-12-18. View