Evaluating Effectiveness of Telerehabilitation Among Workers Admitted to a Posttraumatic Stress Injury Rehabilitation Program.

Abstract

Purpose: Telerehabilitation or hybrid delivery (i.e., a mixture of telerehabilitation and in-person care) was increasingly used to deliver posttraumatic stress injury (PTSI) rehabilitation in response to the COVID-19 pandemic. Limited research, however, has evaluated the use of telerehabilitation to deliver PTSI interventions, including exposure-based therapies, and some service providers concerned about the potential adverse effects of delivery over telerehabilitation continue to advocate for in-person delivery. We evaluated the effectiveness of telerehabilitation versus hybrid delivery in promoting return-to-work (RTW) among workers with PTSI.

Methods: We conducted a pragmatic, quasi-experimental study using archived data from workers undergoing PTSI rehabilitation programs offered by the Workers' Compensation Board of Alberta. The RTW outcomes of workers treated solely using telerehabilitation between November 6, 2020, and September 30, 2021, were compared to outcomes of workers treated using a hybrid model of delivery. A logistic regression analysis was used to examine if the method of treatment delivery was associated with RTW outcomes while controlling for a variety of potential confounders.

Results: The study cohort included 222 workers with ongoing workers' compensation claims for PTSI. The majority were middle-aged (mean 42 years) men (61%) working as public safety personnel (35.9%) or in transport occupations (25.2%). The adjusted regression model showed no statistically significant differences in RTW outcomes between workers receiving telerehabilitation or hybrid treatment (Adjusted Odds Ratio 1.7; 95% CI 0.8-3.6).

Conclusion: PTSI rehabilitation programs delivered exclusively via virtual means appear to produce RTW outcomes that are equally effective to delivery using a hybrid model.