Implementation of a novel video telehealth program for musculoskeletal disorder self-management in U.S. military veterans during the COVID-19 pandemic combining yoga therapy with education

Background Musculoskeletal disorders (MSDs) are highly prevalent, costly, and burdensome. Over 40% of United States military veterans are diagnosed with chronic pain related to the spine. Various clinical practice guidelines recommend nonpharmacological treatments for the management of chronic MSDs including spinal pain. During the COVID-19 pandemic, face-to-face healthcare was diverted to telehealth platforms to minimize exposure of communicable disease. To address barriers to in-person treatment, veterans experiencing pain associated with MSDs at one Veterans Health Administration Medical Center were offered a novel evidence-based approach incorporating patient education and experiential movement through a telehealth modality. Methods We describe a novel telehealth clinic for self-management of MSDs offered from February 2021 to September 2021. The clinic consisted of a one-hour class offered weekly for four weeks, and included didactic lecture content and movement therapy. The classes were offered by a chiropractor and a yoga instructor. We retrospectively evaluated implementation of the telehealth clinic, including program attendance. Attendance of three or more of the four sessions (75%) was selected as a pragmatic descriptive indicator of patient participation. Results Seventeen veterans participated in three cohorts over six months. The mean age of participants was 54.8 years (SD: 14.6; range 34 to 80), and 12 (70.6%) were male. Seven participants (41.2%) attended at least three of the four sessions, including five (29.4%) who attended all four sessions. Participants represented a geographically diverse population, with varying distances from VA facilities and VA facilities with chiropractic services. Conclusions We describe a clinical demonstration of a telehealth clinic for MSDs offering evidence-based content with experiential movement. This program was delivered through video telehealth and a subset of participants sustained attendance across most of the four-session series. The preliminary information reported could be used for development and expansion of this type of clinic for telehealth chronic MSD management. Future studies are needed to determine the impact of telehealth delivery of MSD care on outcomes, cost, and patient preference. Expanding telehealth delivery of MSD care may be particularly valuable for rural veterans, those lacking access to transportation, or patients who experience barriers to attending in-person appointments.