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

Abstract

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). ANOVAs and 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 slight majority of 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.