Abstract
Objective To develop a brief, focused telehealth physical examination for use in the outpatient setting by sports medicine physicians, pediatricians, neurologists, and primary care physicians.
Background Telemedicine has become a key resource for addressing healthcare access limitations for individuals living in rural communities. The COVID-19 pandemic has forced physicians and other healthcare providers to adopt telemedicine practices. Published literature guiding the evaluation of patients with concussion via telemedicine is sparse.
Design/Methods The Buffalo Concussion Physical Examination (BCPE) is a practical and pertinent clinical assessment that helps to diagnose concussion and that has prognostic value when repeated over the first weeks after injury. An interdisciplinary team with experience in telemedicine services utilized a modified-Glaser approach to consensus to translate elements of the BCPE into virtual methods enabling clinicians to provide care to patients over the internet.
Results The Telehealth version of the BCPE (Tele-BCPE) includes an orthostatic intolerance screen, examination of the cranial nerves, and tests of the oculomotor, vestibular and cervical systems. History and examination templates as well as detailed instructions for performance are included. The Tele-BCPE is meant to be used at initial and follow-up visits for patients acutely after concussion as well as in those with prolonged symptoms.
Conclusions We developed a telehealth physical examination to help direct treatment to patients at any stage after concussion and reduce barriers to healthcare access posed by the COVID-19 pandemic and for patients living in rural or underserved areas. Prospective evaluation of the validity and reliability of the Tele-BCPE for the diagnosis and management of patients with concussion is warranted.
Footnotes
Disclosure: Mr. McPherson has nothing to disclose. Dr. Saleem has nothing to disclose. Mr. Haider has received personal compensation in the range of $5,000–$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for BlinkTBI. The institution of Mr. Haider has received research support from NIH. Mr. Haider has received personal compensation in the range of $500–$4,999 for serving as a Statistician with Oculogica. Dr. Leddy has received personal compensation in the range of $500–$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Neurolign. Dr. Leddy has received personal compensation in the range of $500–$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Stage 2 Contract Engineering. Dr. Leddy has received stock or an ownership interest from Highmark Innovations. The institution of Dr. Leddy has received research support from NIH. The institution of Dr. Leddy has received research support from DoD. The institution of Dr. Leddy has received research support from AMSSM. Daniel Torres has nothing to disclose. Prof. Willer has nothing to disclose.
- © 2021 American Academy of Neurology
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