Evidence map›Paper›PMID 40876877›Full record

Trial reportBMJ open2025

Management of musculoskeletal conditions with remotely delivered physiotherapy versus face-to-face physiotherapy: process evaluation of the REFORM trial using the Realist Evaluation and the RE-AIM Framework.

Jackie Chu, Hannah G Withers, Joanne V Glinsky, Hueiming Liu, Matthew D Jennings, Ian J Starkey, Blake Palmer, Rachel Parmeter, Jackson J Cruwys, Max Boulos and 11 more

Abstract readEquivalence TrialMulticenter StudyPragmatic Clinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Jackie ChuKolling Institute, The University of Sydney Faculty of Medicine and Health, St Leonards, New South Wales, Australia.ORCID http://orcid.org/0000-0001-5810-2788
Hannah G WithersKolling Institute, The University of Sydney Faculty of Medicine and Health, St Leonards, New South Wales, Australia.ORCID http://orcid.org/0000-0001-5319-7757
Joanne V GlinskyKolling Institute, The University of Sydney Faculty of Medicine and Health, St Leonards, New South Wales, Australia.
Hueiming LiuUniversity of New South Wales, The George Institute for Global Health, Sydney, New South Wales, Australia.ORCID http://orcid.org/0000-0001-9077-8673
Matthew D JenningsAllied Health Services, Liverpool Hospital, Sydney, NSW, Australia.
Ian J StarkeyPhysiotherapy Department, Blacktown and Mount Druitt Hospital, Blacktown, New South Wales, Australia.
Blake PalmerPhysiotherapy Department, Blacktown and Mount Druitt Hospital, Blacktown, New South Wales, Australia.
Rachel ParmeterPhysiotherapy Department, Blacktown and Mount Druitt Hospital, Blacktown, New South Wales, Australia.
Jackson J CruwysPhysiotherapy Department, Camden and Campbelltown Hospital, Sydney, NSW, Australia.
Max BoulosPhysiotherapy Department, Camden and Campbelltown Hospital, Sydney, NSW, Australia.
Ian JordanPhysiotherapy, Hornsby and Ku-ring-gai Hospital, Hornsby, New South Wales, Australia.
Maggie DuongPhysiotherapy, Bankstown-Lidcombe Hospital, Bankstown, New South Wales, Australia.
Kitty DuongPhysiotherapy Department, Camden and Campbelltown Hospital, Sydney, NSW, Australia.
David WongPhysiotherapy Department, Liverpool Hospital, Sydney, NSW, Australia.
Tara E LambertPhysiotherapy, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
Barbara R LucasPhysiotherapy, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
Deborah TaylorPhysiotherapy, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
Christopher G MaherInstitute of Musculoskeletal Health, The University of Sydney, Sydney, New South Wales, Australia.ORCID http://orcid.org/0000-0002-1628-7857
Catherine SherringtonInstitute of Musculoskeletal Health, The University of Sydney, Sydney, New South Wales, Australia.ORCID http://orcid.org/0000-0001-8934-4368
Joshua R ZadroInstitute of Musculoskeletal Health, The University of Sydney, Sydney, New South Wales, Australia.ORCID http://orcid.org/0000-0001-8981-2125
Lisa A HarveyKolling Institute, The University of Sydney Faculty of Medicine and Health, St Leonards, New South Wales, Australia lisa.harvey@sydney.edu.au.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe objectives of this process evaluation were to explain the results of the REFORM (REhabilitation FOR Musculoskeletal conditions) trial and identify potential facilitators and barriers to the future rollout of a remotely delivered physiotherapy model of care.

settingOutpatient physiotherapy units in five government-funded public hospitals in Sydney, Australia.

designThis process evaluation was run alongside the REFORM trial. The REFORM trial (n=210) set out to determine whether remotely delivered physiotherapy (with one initial face-to-face session with a physiotherapist) was as good or better than a course of face-to-face physiotherapy. The process evaluation was informed by The UK Medical Research Council Process Evaluation Guidance. It was also based on the Realist Evaluation and the dimensions of the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) Framework. Qualitative and quantitative data were collected. The qualitative data included semistructured interviews. The quantitative data included audits of screening logs and participants' self-reported satisfaction with service delivery. A thematic analysis using both inductive and deductive approaches was used for qualitative analysis. Multiple data were used to triangulate the process evaluation findings.

participantsQuantitative data were collected on 210 participants. Qualitative interviews were conducted with 20 participants, 15 physiotherapists and 5 stakeholders.

resultsSome participants valued the convenience and accessibility of remotely delivered physiotherapy. It was also deemed to have the potential of improving the efficiency in the way physiotherapy is delivered. The findings from the RE-AIM framework were mixed. For example, the

conclusionRemotely delivered physiotherapy has the potential to be rolled out across Australian clinical settings to participants similar to the REFORM trial. However, further research involving participants with different types and severity of musculoskeletal conditions is needed to improve the generalisability of our findings. Adoption might be improved with a hybrid model of care where physiotherapists' and patients' preferences are met. TRIAL REGISTRATION NUMBER: ACTRN12619000065190.

Indexed as

Musculoskeletal DiseasesPhysical Therapy ModalitiesAdultAustraliaFemaleHumansMaleMiddle AgedPatient SatisfactionProcess Assessment, Health CareQualitative ResearchExerciseHealth Services AccessibilityImplementation ScienceMusculoskeletal disordersQUALITATIVE RESEARCHSelf-Management

Identifiers

PMID40876877
PMCPMC12410685

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.