Patient Engagement, Clinical Outcomes, and Satisfaction of an Advanced Orthopedic Virtual Physical Therapy Model: A Retrospective Cohort Study.

Abstract

To evaluate access, clinical outcomes, engagement, and satisfaction associated with an advanced musculoskeletal virtual care model. Retrospective cohort study of adults with musculoskeletal complaints referred to advanced orthopedic virtual physical therapy by Physical Medicine and Rehabilitation providers between July 2024 and April 2025. Outcomes included access to care, patient-reported outcome measures, pain intensity, plan-of-care completion, and patient satisfaction. Of 137 referred patients, 86 (62.8%) completed evaluations; 70.9% of those (n=61) completed full care episodes - exceeding national completion benchmarks (71% vs. 43%). Among completers, 96% achieved Minimal Clinically Important Differences. Functional improvements were significant: Oswestry Disability Index -32.4, Neck Disability Index -29.5, Lower Extremity Functional Scale +26.6 (all P<.001). Pain decreased from 6.1 to 0.9 (-85%). Average care required 5.6 visits versus national benchmarks of 6-10. Patient satisfaction was exceptional (Net Promoter Score=100). Among patients who completed a full episode of care, this advanced virtual musculoskeletal model was associated with substantial functional improvement, pain reduction, and high satisfaction while requiring fewer visits than national averages. Because outcome analyses were limited to completers, these findings may not represent all referred patients. Prospective controlled studies are needed to evaluate effectiveness and scalability.