Compliance with remotely monitored physical therapy is higher in the older age group and for treatment of the upper extremity

Kanwar Parhar; Yousef Shishani; Abigail Berns; Reuben Gobezie; Patrick Denard

DOI: 10.70885/hmsj.2025.03.001

Abstract

Background: Remotely monitored physical therapy (RMPT) has emerged as an efficacious and cost-effective alternative to in-office physical therapy. These platforms enable real-time progress tracking, adjustments to patient care plans, and provide feedback to motivate patients to improve their health status. However, little data is available with regards to compliance which may vary based on age given the technology required for use.Purpose: To evaluate compliance with RMPT in different age groups across different body regions. Our hypothesis was that elderly patients would demonstrate similar compliance to younger patients with an RMPT program.Methods: A consecutive series of patients that underwent RMPT from Jan. 2022 to Jan. 2024 at 8 institutions were selected for the study. Compliance was stratified as low (<33% completion of exercises), moderate (33-66% completion of exercises), or high (>66% completion of exercises). Data collected included demographic data, body region (upper extremity, lower extremity, or spine), compliance and duration of RMPT.Results: A total of 2019 patients with an average age of 61.7 ± 12.9 years and rehabilitation duration of 23.7 ± 5.8 weeks were included in this analysis. Among these, 1735 (85.9%) underwent RMPT for the upper extremity, 244 (12.1%) lower extremity condition, and 40 (2%) for a spine condition. Compliance increased with advancing age (p < 0.001). High compliance was seen in 23.7% of the upper extremity cohort, compared to 15.6% in the lower extremity cohort and 7.5% in the spine cohort (p = 0.002). Overall, compliance rates were moderate or high in 66% of patients.Conclusion: Despite requiring familiarity with technology, older patients demonstrate improved compliance with RMPT compared to younger patients. Compliance also appears to vary by body region with the highest compliance seen for the upper extremity and lowest compliance seen for the spine.What this study adds: This study demonstrates that older adults exhibit higher compliance rates than younger individuals. Clinically, this study supports the integration of RMPT into routine physical therapy practice, particularly for older patients and those with upper extremity conditions.Potential impacts on research, practice, or policy: This study highlights the potential for RMPT to enhance compliance among older adults, challenging traditional assumptions about technology adoption in this demographic. These findings may inform healthcare policies aimed at improving patient engagement and accessibility in older adults.Study Design: Retrospective Case SeriesLevel of Evidence: Level 4Keywords: Remotely monitored physical therapy; Physical Rehabilitation; Gamification; Compliance; Older adultshttps://doi.org/10.70885/hmsj.2025.03.001

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