Affiliation:
1. Internal Medicine Stanford University School of Medicine Stanford California USA
2. Division of Colorectal Surgery, Department of Surgery Stanford University School of Medicine Stanford California USA
3. Stanford Health Care Stanford California USA
4. Quantitative Sciences Unit Stanford University School of Medicine Stanford California USA
5. Division of Gastroenterology and Hepatology Stanford University School of Medicine Stanford California USA
Abstract
AbstractBackgroundTelehealth utilization, largely spurred by the COVID‐19 pandemic, has become popular due to convenience and access. We assessed the effectiveness of telehealth for delivering pelvic health physical therapy (PHPT) in patients with pelvic floor disorders (PFD).MethodsIn this IRB approved, cross‐sectional study, 812 patients who underwent PHPT treatment by telehealth or in combination with in‐person visits were surveyed. Post intervention effectiveness was analyzed using Patient Global Impression of Change (PGIC) and short form Pelvic Floor Impact Questionnaire (PFIQ‐7).ResultsOne hundred and forty‐one patients, 80% female, mean (SD) age of 52 (17) completed the study. The mean number of encounters was 4.55 (4.25) with 2.81 (2.08) telehealth visits. A total of 42 (30%) patients reported no change/worse, 27 (19%) minimal, and 72 (51%) moderate/much improvement of symptoms consistent with a lower PFIQ‐7 scores. Patients who reported improvement were significantly younger (p < 0.002). Age was the only independent factor that could predict response to PHPT. Patients <50 years old reported significantly more symptom improvement (p < 0.02), symptom resolution (p < 0.002), meeting personal goals (p < 0.0001), improved muscle strength, coordination, and relaxation (p < 0.05), greater satisfaction with bowel movements, and less negative impact of bowel on quality of life (p < 0.005) than older patients. Regardless of age, 89 (64%) patients preferred hybrid telehealth visits.Conclusion & InferencesUtilizing telehealth alone or in a hybrid format combined with in‐person visits for PHPT appears to be preferred by patients and associated with subjective report of improvement of symptoms. However, efficacy of telehealth interventions in older adults warrants further studies.