Addressing safety and comprehensiveness concerns for neurological examination via telehealth in patients with low back pain

Low back pain (LBP) is a leading cause of disability globally. A neurological examination is standard practice in the assessment of patients with LBP-related symptoms, informing clinical diagnosis and management decisions. Failure to adequately identify neurological compromise can have serious consequences for the patient and health service alike. There has been a recent shift towards managing patients with LBP via telehealth (specifically video-conferencing), particularly in response to the global COVID-19 pandemic. While experts have provided their perspectives regarding how individual neurological examination tests can be modified to a telehealth environment, no studies have formally established level of agreement when performing these tests via telehealth (compared to in-person examination).

Members of the RBWH Physiotherapy and Neurosurgery Departments (sponsored by the RBWH Foundation) came together to address concerns raised by our clinicians regarding safety and appropriateness.

A manuscript titled “Addressing safety and comprehensiveness concerns for neurological examination via telehealth in patients with low back pain” is currently in preparation.

Education resources have been developed to support translation of findings into clinical practice, as well as to guide clinician decisions around the appropriateness of performing a neurological examination via telehealth.

Examination Proformas:

• Telehealth Neurological Examination Proforma
• In-person Neurological Examination Proforma