Date Presented 03/22/24

The purpose of this mixed-methods study was to determine hand therapists’ perspectives on telehealth with upper extremity rehabilitation. Through surveys, viewpoints of hand therapists on telehealth were obtained to close the research gap.

Primary Author and Speaker: Gwen Morris

PURPOSE: The purpose of this project was to determine perspectives of hand therapists using telehealth for upper extremity rehabilitation.

DESIGN: Mixed Methods.

METHOD: Participants were contacted through active membership of the American Society of Hand Therapists (ASHT). The online survey took 15-30 minutes to complete. Data were analyzed with descriptive statistics for demographic information including age, gender, profession, entry-level professional degree, highest level of education, years of practice, years in hand therapist role, if they had certified as a CHT through the Hand Therapy Certification Commission, geographic setting of their practice, primary practice setting, and caseload insurance. Qualitative questions pertaining to perspectives on telehealth, perceived assets and barriers were included in the qualitative portion of thematic data analysis.

RESULTS: Preliminary results include increased utilization of telehealth services when compared to pre-COVID restrictions. Barriers include lack of technology, a lack of objective measures, and lack of hands-on treatment interventions. Assets include reimbursement by insurance and flexible scheduling.

CONCLUSION: Telehealth for outpatient hand therapy can be a viable option for alternative treatment however, hand therapist prefer in-person treatment to reduce barriers to obtain objective data and performing manual therapy interventions.

IMPACT STATEMENT: Currently occupational therapists make up at least 75% of the certified hand therapy population. Occupational therapists who have certified as hand therapists have practice patterns and preferences which were influenced by the changes during the COVID-19 pandemic. While telehealth is an approved treatment platform, barriers are limiting the use of telehealth for outpatient hand therapy practice. Additional research may be beneficial to support the use of telehealth services such as obtaining objective data in a virtual environment.

References

Butzner, M. & Cuffee, Y. (2021). Telehealth interventions and outcomes across rural communities in the United States: Narrative review. Journal of Medical Internet Research 23(8). https://www.doi.org/10.2196/29575

Harper, K. J., Fitzgerald, S., & Xiyin, P. (2022). Does the integration of telehealth into occupational therapy practice impact clinical outcomes for hand and upper limb rehabilitation? A matched case control study. International Journal of Telerehabilitation, 14(2). http://www.doi.org/10.5195/ijt.2022.6505

Pullyblank, K. (2023). A scoping literature review of rural beliefs and attitudes toward telehealth utilization. Western Journal of Nursing Research, 45(4), 375–384. http://www.doi.org/10.1177/01939459221134374

Alford, S., Tietz, J., Munro, M., Greiner, K., Dickens, J., & Cochren, A. (2019). The reliability of the iPhone leveling application in measuring forearm and wrist range of motion: implications for use in telehealth. American Journal of Occupational Therapy, 73(Supplement 1), 7311500051p1. https://doi.org/10.5014/ajot.2019.73S1-PO8017