Remotely delivered physiotherapy for musculoskeletal conditions

Abstract

Musculoskeletal (MSK) conditions are common, and physiotherapy treatment is traditionally provided in an outpatient setting with face-to-face sessions. Accessing this treatment can be difficult and inconvenient with long waitlists and significant costs to both the health system and patients. Current evidence suggests that it may be possible to move some patients with specific MSK conditions away from face-to-face treatment and replace it with more flexible and accessible treatment delivered remotely. However, there is a lack of evidence clearly indicating that remotely delivered physiotherapy for MSK conditions can achieve good patient outcomes, increase patient access to treatment and be cost effective from both the health system and patient perspective. The content of this thesis aims to investigate these areas where evidence is lacking. This thesis is organised into 7 chapters, each written so it can be read independently. Chapter 1 is an introduction to this thesis and presents an overview of the current burden of the treatment of musculoskeletal conditions, and the difficulties some people have accessing timely and affordable physiotherapy. This chapter draws attention to the gaps in the literature which are addressed by the studies presented in the following chapters. Chapters 2 and 3 are published study protocols and Chapters 4 and 5 consist of studies that have been published in peer-reviewed journals. These studies have been presented in the format in which they have been published. Chapter 6 consists of a draft of a study that has been prepared for submission to a journal for peer review. This study is presented in the format in which it will be submitted. Chapter 7 presents a discussion about the key findings from this body of work, and the clinical implications and recommendations for future research based on these findings.