While certain kinds of digital physical therapy programs can benefit people with musculoskeletal conditions, more evidence is required for other tools, researchers say.
A report published Thursday by the nonprofit research firm Peterson Health Technology Institute found mixed results regarding digital health tools' costs and clinical efficacy.
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Researchers, who used the same framework as in the group’s previous report raising questions regarding the efficacy of digital diabetes management tools, conducted a systematic literature review of 48 studies evaluating the clinical effectiveness of various kinds of virtual physical therapy technologies. The report authors cautioned they did not include clinical data from each company's tools.
When determining economic effect, report authors used models estimating the number of adults who use in-person physical therapy for lower back pain and could be eligible for virtual physical therapy tools across commercial, Medicare and Medicaid plans.
Researchers expressed the most optimism about what they called "physical therapist-guided solutions," which they defined as those offering a high level of clinical involvement in exercise design and care management. They found tools of the kind offered by Hinge Health, Omada Health, RecoveryOne, Sword Health and Vori Health improved pain and function.
The category's technology was also shown to decrease spending relative to in-person care, according to the report. Evidence supported broader adoption of these kinds of tools, researchers said.
The researchers took a more measured view of app-based exercise therapy, in which care plans are usually designed and updated by algorithms, and remote therapeutic monitoring-augmented physical therapy, which uses virtual services to complement in-person care.
The app-based therapy category included tools offered by Dario Health and Kaia Health. App-based therapies generally improved pain but not function and were not substitutable for in-person care, researchers found. Pricing information on the tools was not available, but researchers said the evidence supported broader adoption depending on the cost, especially for less severe conditions.
RTM-augmented physical therapy tools such as those from Limber may perform better than in-person therapy alone, but they also increase net spending, according to the report. More evidence could justify broader adoption for patients with more severe conditions, researchers said.
“For a subset of these solutions that have more physical therapist involvement they are actually an effective substitute for in-person [physical therapy],” said Caroline Pearson, executive director at the Peterson Health Technology Institute.
Although researchers examined the cost of the tools' use for lower back pain, Pearson said the technology can be tapped for other conditions.
“There is so much growth potential in the MSK space because so many people right now would benefit from physical therapy that don’t get it,” Pearson said. “These companies are currently competing with one another on a limited-sized pie. We could grow this pie significantly.”
Sword and RecoveryOne expressed approval of the report in response to requests for comment. Sword on Tuesday announced new funding and an artificial intelligence-powered care specialist service that interacts with patients autonomously.
Kaia Health said in a statement it appreciated Peterson’s efforts to develop standards in understanding the impact of tools. The company said it disagreed "with many of the generalized categorizations and conclusions" and said the report “seem[ed] to be based on limited knowledge of Kaia.” It said the chosen studies represented only two of more than a dozen published that support Kaia's clinical and qualitative efficacy.
A spokesperson from DarioHealth declined to comment, stating the company was still reviewing the results.
Spokespeople from Hinge, Limber, Omada and Vori did not immediately respond to requests for comment.
Pearson has previously said the institute’s research is funded entirely by the Peterson Center on Healthcare. The New York-based nonprofit group announced it would launch the center in July 2023 to evaluate digital health technologies. The center was founded by the late Pete Peterson, co-founder of asset manager Blackstone and a former U.S. secretary of commerce under former President Richard Nixon.
