Addressing Opportunities and Barriers in Telehealth Neurologic Physical Therapy: Strategies to Advance Practice.

BACKGROUND AND PURPOSE: Since the COVID-19 pandemic, the use and implementation of telehealth has expanded, with implementation moving ahead of best practice recommendations due to necessity. Telehealth has improved access and care coordination for patients with various neurologic conditions; however, information regarding therapeutic intensity, safety, and appropriateness is lacking. In 2021, the Academy of Neurologic Physical Therapy formed a Telehealth Taskforce to provide clinical and educational resources for its members and the neurologic physical therapy (PT) community. The purpose of this special interest article is to provide consensus-driven best practice resources developed by the Taskforce and describe the process of creating these resources to assist with telehealth implementation in neurologic PT practice, advocate for continued utilization, and shine light on opportunities for future research. SUMMARY OF KEY POINTS: In this special interest article, we describe the process, challenges, and opportunities of developing and disseminating resources to educate, train, and support telehealth implementation in neurologic clinical practice. Four key strategies to facilitate telehealth implementation emerged: (1) increase knowledge of resources related to telehealth and mobile applications; (2) develop and disseminate evidence-based and consensus-based best practice recommendations for telehealth in neurologic PT; (3) provide future recommendations for integrating telehealth in PT, education, research, and clinical practice; and (4) encourage advocacy for inclusion of telehealth within the PT community. We explain the need to continue research and provide recommendations to expand telehealth research in neurologic clinical practice. RECOMMENDATIONS FOR CLINICAL PRACTICE: This article highlights the potential and future of telehealth in neurologic PT practice. Our recommendations provide current clinical tools and resources for telehealth implementation following a knowledge-to-action framework and suggest areas for future research.Video Abstract available for more insights from the authors (see the Video, the Supplemental Digital Content, available at: http://links.lww.com/JNPT/A447).

Outcome measures in neurological physical therapy practice: part II. A patient-centered process.

Physical therapists working in neurological practice must make choices about which standardized outcome measures are most appropriate for each patient. Significant time constraints in the clinic limit the number of measures that one can reasonably administer. Therapists must choose measures that will provide results that guide the selection of appropriate interventions and are likely to show clinically meaningful change. Therefore, therapists must be able to compare the merits of available measures to identify those that are most relevant for each patient and setting. This article describes a process for selecting outcome measures and illustrates the use of that process with a patient who has had a stroke. The link between selecting objective outcome measures and tracking patient progress is emphasized. Comparisons are made between 2 motor function measures (the Fugl-Meyer Assessment [FMA] of Physical Performance vs the Stroke Rehabilitation Assessment of Movement), and 2 balance measures (Berg Balance Scale vs the Activities-specific Balance Confidence Scale). The use of objective outcome measures allows therapists to quantify information that previously had been described in subjective terms. This allows the tracking of progress, and the comparison of effectiveness and costs across interventions, settings, providers, and patient characteristics.