June 30, 2023 • min read
Systematic review proves the effectiveness of digital physical therapy
Written by

Sword Editorial Team
Experts in pain, movement, and digital health

In the first-ever systematic review of its kind, Sword Health researchers showed that asynchronous telerehabilitation with biofeedback (known more broadly as digital physical therapy) is effective in improving pain and function in patients with musculoskeletal (MSK) conditions.
Keep reading to learn about the peer-reviewed study, published in Digital Health.
What is telerehabilitation?
The term describes the digital health care delivery model of live video conferencing between physical therapy provider and patient
What is biofeedback and how does it relate to physical therapy?
Biofeedback is a mind-body technique that uses sensors and devices to measure your body’s physiological signals (including things like muscle tension, heart rate, or breathing patterns). The mechanism feeds this information back to in real time, allowing the patient or clinician to make small, intentional changes. This revolutionary technology allows digital physical therapy care models to improve health and performance without in-person clinic visits.
How does biofeedback enable digital physical therapy?
Biofeedback enables both the patient and the clinician to see how your muscles fire and move, helping you correct patterns that may be causing pain or holding you back.
Why is digital physical therapy more widely used?
Exercise-based physical therapy is a clinically and cost-effective treatment for MSK conditions, which are the leading cause of disability worldwide. As the evolution in digital healthcare technology developed and improved, the use of synchronous telerehabilitation has gained more and more popularity as an accessible alternative to in-person treatment.
About the study: measuring the effectiveness of biofeedback with telerehabilitation
Until now, however, there was no systematic review evaluating the effectiveness of this type of asynchronous treatment.
Previous systematic reviews support the effectiveness of synchronous telerehabilitation in patients with MSK conditions. However, this kind of treatment still requires physical therapists (PTs) to meet one-on-one with patients during every session.
This poses scalability and scheduling issues, as many patients are unable to consistently attend appointments during regular working hours. There is also an ongoing shortage of PTs in the U.S., which can create long waiting lists and additional schedule constraints. This means synchronous telerehabilitation (or the traditional in-clinic PT delivery model) cannot adequately tackle the growing need for physical therapy services.
This is why asynchronous telerehabilitation with biofeedback has emerged as a more scalable solution for the treatment of MSK pain.
How biofeedback overcomes the barriers of traditional PT care models
- Patients can complete their recovery prorgam from home without the challenge of scheduling appointments or commuting to a clinic
- The physical therapy provider does not need to observe the session in real time with biofeedback and telerehabilitation enabling effective care
- This solution allows patients to complete their prescribed exercises on their own schedule at a location that suits their lifestyle
- Clinicians and care providers can use biofeedback and adherence metrics remotely to adjust the treatment as needed
- The added accountability of this progress tracking combined with the flexibility of the care model leads to increased engagement rates
Methods of the telerehabilitation research study
Sword researchers’ systematic review focused on trials published in the last five years to summarize and assess the effectiveness of asynchronous, exercise-based telerehabilitation incorporating biofeedback. In total, 14 papers were included and analyzed. Among them were eight randomized control trials, three non-randomized control trials, and three single-arm studies.
The majority of studies used wearable inertial motion sensors to provide biofeedback during exercise sessions, while four studies used camera-based sensors. All studies included some form of communication system between health professionals and patients, but only six studies allowed patients to reach out as needed.
Results prove digital PT is as effective as traditional care with lower costs
The systematic review showed that asynchronous, exercise-based telerehabilitation incorporating wearable motion sensors is effective in improving pain and function in patients with MSK conditions, yielding at least similar improvements as compared to usual care (including in-person rehabilitation).
The results of this study reinforce the effectiveness of digital solutions such as Sword Health in treating MSK conditions, which is excellent news for patients, providers, and employers. Digital MSK programs allow patients to get the treatment they need from the comfort of their homes, as soon as they need it. In other words, the relative accessibility of digital MSK increases the likelihood of patients receiving timely and proper care, which is a key factor in avoiding unnecessary surgeries and other invasive procedures down the line.
Meanwhile, providers can effectively treat more patients in less time. And employers can tackle MSK issues in their workforce using a solution that is just as effective as in-person physical therapy and synchronous telerehabilitation, but less costly and much more convenient.
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