Delivering Virtual Cancer Rehabilitation Programming During the First 90 Days of the COVID-19 Pandemic: A Multimethod Study.
Christian J Lopez, Beth Edwards, David M Langelier and 3 others
PMID 33617864WHAT IT FOUND
Virtual cancer rehab kept high attendance and increased visit volume during the pandemic.
However, therapists found assessing physical impairments and teaching exercises difficult without in-person exams. Video was preferred over phone, and an initial in-person assessment was recommended for complex cases.
Key findings
01Virtual care delivery resulted in high attendance rates (80%-93%) and increased the total number of completed visits compared to the previous in-person period.
02Health care providers reported significant difficulties in assessing musculoskeletal, neurologic, and lymphedema impairments virtually, often relying on patient self-report due to the inability to physically examine or observe movement accurately.
03Participants preferred video-based appointments over telephone visits for building rapport and confidence in care plans, and recommended initial in-person assessments for patients with moderate to severe physical impairments.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
This was a descriptive study of service adaptations, not a controlled trial, so it cannot determine if virtual care is as effective as in-person care. The study was conducted at a single center with a specific pre-existing infrastructure for virtual care, which may not be generalizable to other settings. The qualitative sample was small (12 patients, 12 providers), limiting the depth and transferability of the themes. Process outcomes were not statistically compared to pre-pandemic baselines; differences are descriptive only. Patient demographics were not compared between virtual and in-person cohorts, so selection bias cannot be ruled out.
Declared interests
The study was conducted at the Princess Margaret Cancer Centre. No specific funding sources or conflicts of interest were declared in the provided text, though it mentions a Research Ethics Board waiver.
The easy way to misread this
Do not interpret the high attendance and increased visit volume as evidence that virtual care is clinically equivalent to in-person care for physical rehabilitation. The study explicitly states it did not examine effectiveness, and providers reported significant limitations in assessing physical impairments, which may compromise the accuracy of care plans for complex cases.