February 05, 2020
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Lower health care costs found with virtual vs usual physical therapy for TKA

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Patients who underwent total knee arthroplasty and were assigned to receive virtual physical therapy had significantly lower 3-month health care costs compared to those who had the usual physical therapy care, according to study results. However, the treatments had similar effectiveness and safety.

During the Virtual Exercise Rehabilitation In-Home Therapy: A Randomized Study, researchers randomly assigned 287 patients who underwent TKA to undergo virtual physical therapy with The Virtual Exercise Rehabilitation Assistant (VERA; Reflexion Health) in-home 3D biometrics and telerehabilitation with remote clinician oversight by a physical therapist system (n=143) or traditional physical therapy in the home or outpatient clinic (n=144). According to the study, the virtual physical therapy program used 3D tracking technology that quantified pose and motion and an avatar that demonstrated activity. It provided visual and audible instructions and feedback on the quality of the exercise and offered a virtual video connection for telehealth visits with an intervention telehealth physical therapist.

The total health care cost for the 12-week post-hospital period was the primary outcome. Among the other outcomes were 6- and 12-week KOOS, 6-week knee extension, knee flexion, gait speed and 12-week safety measures. A modified intent-to-treat basis was used to analyze all outcome.

Results showed that at 12 weeks after discharge, the virtual physical therapy had a median cost of $1,050 compared with $2,805 for the usual care. Investigators noted patients in the virtual therapy group had a $2,745 lower mean cost. Fewer rehospitalizations were seen in virtual physical therapy patients compared with the usual care patients (12 patients vs. 30 patients). At 6 and 12 weeks, virtual physical therapy was noninferior to usual physical therapy with regard to the KOOS. Virtual physical therapy compared with usual care was noninferior at 6 weeks with regard to knee extension, knee flexion, gait speed, pain and hospital readmissions at 12 weeks. Overall, 19.4% of patients treated with virtual physical therapy reported falls compared to 14.6% of patients who received usual care. by Monica Jaramillo

Disclosure: The study was funded by Reflexion Health.