Top

Archives of Orthopaedic and Trauma Surgery

Published in:

01-06-2022 | Telemedicine | Orthopaedic Surgery

Shoulder assessment by smartphone: a valid alternative for times of social distancing

Authors: Alon Rabin, Oleg Dolkart, Efi Kazum, Reut Wengier, Yariv Goldstein, Eran Maman, Ofir Chechik

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 6/2022

Abstract

Background

The delivery of orthopaedic care via telemedicine services has the potential to promote accessibility and decrease medical care expenses, while facilitating the control of infectious disease spreading. The purpose of this study was to assess agreement regarding diagnosis, recommended course of management and the perceived need for additional diagnostic testing between a video examination (VE) and a face to face (FTF) assessment of patients with shoulder disorders.

Methods

Forty-seven (18 females) patients presenting to a shoulder surgery clinic were assessed consecutively by VE and a FTF examination. All assessments were conducted by a shoulder specialist. Agreement regarding the established diagnosis, the recommended course of management and the need for additional diagnostic tests was assessed using percent agreement and kappa (95% CI) coefficient. Differences in the content, duration and satisfaction between the two examination modes were also assessed.

Results

Percent agreement and kappa (95% CI) coefficient for agreement regarding diagnosis were 85.1% and 0.82 (0.69–0.94), respectively. Percent agreement and kappa (95% CI) coefficient regarding the recommended course of management and the need for additional diagnostic testing were 61.7% and 0.43 (0.22–0.63), and 74.5% and 0.49 (0.25–0.74), respectively. The VE resulted in collection of less physical examination information, took longer to complete and was associated with less satisfaction by both patient and examiner.

Conclusions

Video examination of patients with shoulder disorders may present a valid alternative to FTF examination. Nevertheless, the content of the video-based physical examination may need to be modified to facilitate a clearer detection of indications for specific interventions or diagnostic tests.

Blank E, Lappan C, Belmont PJ Jr, Machen MS, Ficke J, Pope R, Owens BD (2011) Early analysis of the United States Army’s telemedicine orthopaedic consultation program. J Surg Orthop Adv 20(1):50–55PubMed

Rowell PD, Pincus P, White M, Smith AC (2014) Telehealth in paediatric orthopaedic surgery in Queensland: a 10-year review. ANZ J Surg 84(12):955–959. https://doi.org/10.1111/ans.12753CrossRefPubMed

Haukipuro K, Ohinmaa A, Winblad I, Linden T, Vuolio S (2000) The feasibility of telemedicine for orthopaedic outpatient clinics—a randomized controlled trial. J Telemed Telecare 6(4):193–198. https://doi.org/10.1258/1357633001935347CrossRefPubMed

McGill A, North J (2012) An analysis of an ongoing trial of rural videoconference fracture clinics. J Telemed Telecare 18(8):470–472. https://doi.org/10.1258/jtt.2012.GTH110CrossRefPubMed

Tachakra S, Hollingdale J, Uche CU (2001) Evaluation of telemedical orthopaedic specialty support to a minor accident and treatment service. J Telemed Telecare 7(1):27–31. https://doi.org/10.1258/1357633011936101CrossRefPubMed

Waterman BR, Laughlin MD, Belmont PJ Jr, Schoenfeld AJ, Pallis MP (2014) Enhanced casualty care from a Global Military Orthopaedic Teleconsultation Program. Injury 45(11):1736–1740. https://doi.org/10.1016/j.injury.2014.03.012CrossRefPubMed

Siow MY, Walker JT, Britt E, Kozy JP, Zanzucchi A, Girard PJ, Schwartz AK, Kent WT (2020) What was the change in telehealth usage and proportion of no-show visits for an orthopaedic trauma clinic during the COVID-19 pandemic? Clin Orthop Relat Res 478(10):2257–2263. https://doi.org/10.1097/CORR.0000000000001396CrossRefPubMedPubMedCentral

Mani S, Sharma S, Omar B, Paungmali A, Joseph L (2017) Validity and reliability of Internet-based physiotherapy assessment for musculoskeletal disorders: a systematic review. J Telemed Telecare 23(3):379–391. https://doi.org/10.1177/1357633X16642369CrossRefPubMed

Abboud JA, Bozentka DJ, Beredjiklian PK (2005) Telemedicine consultation for patients with upper extremity disorders is reliable. Clin Orthop Relat Res 435:250–257. https://doi.org/10.1097/01.blo.0000155009.77961.5cCrossRef

10.

Tanaka MJ, Oh LS, Martin SD, Berkson EM (2020) Telemedicine in the Era of COVID-19: The virtual orthopaedic examination. J Bone Joint Surg Am 102(12):e57. https://doi.org/10.2106/JBJS.20.00609CrossRefPubMed

11.

Laskowski ER, Johnson SE, Shelerud RA, Lee JA, Rabatin AE, Driscoll SW, Moore BJ, Wainberg MC, Terzic CM (2020) The Telemedicine musculoskeletal examination. Mayo Clin Proc 95(8):1715–1731. https://doi.org/10.1016/j.mayocp.2020.05.026CrossRefPubMed

12.

Sim J, Wright CC (2005) The kappa statistic in reliability studies: use, interpretation, and sample size requirements. Phys Ther 85(3):257–268CrossRef

13.

Carter T, Hall H, McIntosh G, Murphy J, MacDougall J, Boyle C (2012) Intertester reliability of a classification system for shoulder pain. Physiotherapy 98(1):40–46. https://doi.org/10.1016/j.physio.2010.12.003CrossRefPubMed

14.

de Winter AF, Jans MP, Scholten RJ, Deville W, van Schaardenburg D, Bouter LM (1999) Diagnostic classification of shoulder disorders: interobserver agreement and determinants of disagreement. Ann Rheum Dis 58(5):272–277. https://doi.org/10.1136/ard.58.5.272CrossRefPubMedPubMedCentral

15.

Hanchard NC, Howe TE, Gilbert MM (2005) Diagnosis of shoulder pain by history and selective tissue tension: agreement between assessors. J Orthop Sports Phys Ther 35(3):147–153. https://doi.org/10.2519/jospt.2005.35.3.147CrossRefPubMed

16.

Pellecchia GL, Paolino J, Connell J (1996) Intertester reliability of the cyriax evaluation in assessing patients with shoulder pain. J Orthop Sports Phys Ther 23(1):34–38. https://doi.org/10.2519/jospt.1996.23.1.34CrossRefPubMed

17.

Storheil B, Klouman E, Holmvik S, Emaus N, Fleten N (2016) Intertester reliability of shoulder complaints diagnoses in primary health care. Scand J Prim Health Care 34(3):224–231. https://doi.org/10.1080/02813432.2016.1207139CrossRefPubMedPubMedCentral

18.

Haider Z, Aweid B, Subramanian P, Iranpour F (2020) Telemedicine in orthopaedics and its potential applications during COVID-19 and beyond: aa systematic review. J Telemed Telecare. https://doi.org/10.1177/1357633X20938241CrossRefPubMed

19.

Rizzi AM, Polachek WS, Dulas M, Strelzow JA, Hynes KK (2020) The new “normal”: Rapid adoption of telemedicine in orthopaedics during the COVID-19 pandemic. Injury. https://doi.org/10.1016/j.injury.2020.09.009CrossRefPubMedPubMedCentral

20.

Dupeyron A, Gelis A, Sablayrolles P, Bousquet PJ, Julia M, Herisson C, Pelissier J, Codine P (2010) Heterogeneous assessment of shoulder disorders: validation of the Standardized Index of Shoulder Function. J Rehabil Med 42(10):967–972. https://doi.org/10.2340/16501977-0627CrossRefPubMed

21.

van de Water AT, Davidson M, Shields N, Evans MC, Taylor NF (2015) The Shoulder Function Index (SFInX): a clinician-observed outcome measure for people with a proximal humeral fracture. BMC Musculoskelet Disord 16:31. https://doi.org/10.1186/s12891-015-0481-xCrossRefPubMed

Title: Shoulder assessment by smartphone: a valid alternative for times of social distancing
Authors: Alon Rabin
Oleg Dolkart
Efi Kazum
Reut Wengier
Yariv Goldstein
Eran Maman
Ofir Chechik
Publication date: 01-06-2022
Publisher: Springer Berlin Heidelberg
Keyword: Telemedicine
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 6/2022
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-021-03762-x

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Shoulder assessment by smartphone: a valid alternative for times of social distancing

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 6/2022

Similar biomechanical properties of four tripled tendon graft models for ACL reconstruction

Autogenous iliac crest bone grafting for tibial nonunions revisited: does approach matter?

Identification of hip fracture patients at risk for postoperative mobilisation complications via handgrip strength assessment

The role of the femoral component orientation on dislocations in THA: a systematic review

Undercorrection: the undesired effect of compression on the osteotomy gap of the medial opening wedge high tibial osteotomy and its clinical significance

Additional coracoclavicular augmentation reduces revision rates in the treatment of lateral clavicle fractures as compared to angle-stable plate osteosynthesis alone