Implementation and Patient Satisfaction of Telemedicine in Spine Physical Medicine and Rehabilitation Patients During the COVID-19 Shutdown.

OBJECTIVE: The aim of the study was to investigate the implementation and patient satisfaction of telemedicine visits in a physical medicine and rehabilitation spine practice during COVID-19. DESIGN: This is a prospective cohort study. RESULTS: Of 172 patients, 97.6% were very satisfied or satisfied (83.7% of the patients were very satisfied) with their telemedicine appointment. In 44.4% of the cases, the physical medicine and rehabilitation physician prescribed medication to the patient, and in 21.6% of the cases, either an injection or radiofrequency ablation was ordered. Most patients (87%) did not have any issues during their encounter. Lastly, 64.5% of the patients preferred telemedicine over in-person appointments, whereas 56.1% of the patients who are 60 yrs and older responded the same. A total of 67.4% of those who had a follow-up visit would choose telemedicine over in-person. CONCLUSIONS: The results of this study show that telemedicine can provide very effective and satisfactory care in a physical medicine and rehabilitation spine practice. This was especially notable with follow-up visits where imaging and treatment plan can easily be discussed over telemedicine. Stay-at-home orders and improved reimbursement during the COVID-19 pandemic have spurred adoption of telemedicine with high patient satisfaction. We hope that physical medicine and rehabilitation physicians will be able to continue expanding patient access in the postpandemic world.

Calcaneal quantitative ultrasound compared with hip and femoral neck dual-energy x-ray absorptiometry in people with a spinal cord injury.

OBJECTIVE: To evaluate the sensitivity and specificity of calcaneal quantitative ultrasound (QUS) measurements for identifying osteoporosis determined by dual-energy x-ray absorptiometry (DXA) at the hip in a spinal cord injury (SCI) population. DESIGN: Cross-sectional retrospective review of data collected in the bone health registry of persons with a disability. SETTING: Inpatients and outpatients at a single acute rehabilitation hospital. PARTICIPANTS: A convenience sample of 66 participants, both inpatients and outpatients, with a spinal cord injury. METHODS: Calcaneal T scores were determined by ultrasound, and bone density of the lumbar spine, total hip, and femoral neck were determined by DXA. MAIN OUTCOME MEASUREMENTS: Right and left calcaneal QUS T scores and right and left hip and femoral neck DXA T scores. RESULTS: Right and left hip DXA T scores were strongly associated with corresponding right and left calcaneal QUS T scores (right: r = .72, P < .001; left: r = .70, P < .001). Similar associations were found when we evaluated femoral neck T scores and calcaneal QUS T scores. Receiver operating characteristic analysis for evaluating QUS to identify DXA-defined osteoporosis demonstrated an area under the curve of 0.81 for all participants (acute and chronic injury) and 0.68 for those with a chronic SCI. CONCLUSIONS: A strong association exists between calcaneal QUS T scores and bone density T scores at the hip measured by DXA. QUS may have a place in the screening of people with SCI 1 year or more after their injury to evaluate their bone status.