A retrospective analysis of 4,662 female patients found that virtual pelvic health physical therapy produced outcomes comparable to in-person and hybrid care, according to Liz Miracle, a board-certified pelvic floor physical therapist and Head of Clinical Quality at Origin. The study’s findings challenge long-standing assumptions about the necessity of face-to-face interactions in specialized rehabilitation.
No clear advantage for in-person care
Patients treated through virtual, hybrid, and in-person settings showed similar improvements, with no statistically significant differences in outcomes, Miracle said. The study, published in a white paper by Origin, tracked patients treated between June 2022 and June 2024—2,833 in-person, 1,536 hybrid, and 293 virtual. The lack of significant variation across groups was determined using the Pelvic Floor Distress Inventory-20 (PFDI-20), a validated tool that quantifies the severity of pelvic floor disorders by evaluating three key domains: pelvic organ prolapse, urinary incontinence, and colorectal-anal symptoms.
The majority in all three settings achieved clinically meaningful improvement on the PFDI-20, and no pairwise between-group comparison reached Bonferroni-corrected significance (required threshold P < 0.0167).
Miracle emphasized that the analysis defined virtual care strictly, distinguishing it from mixed-setting models often labeled virtual elsewhere. “When you read a study, it will say virtual, but when you actually get into the study and read it, they are describing what would be a hybrid plan of care, so that there is still some in-person component to it,” she said. “In our report, when we talk about virtual, virtual was truly virtual, and it was 45-minute sessions 1-on-1 with a physical therapist.” That equivalence in supervised time across settings, she noted, is a distinguishing feature of the model. Additionally, Miracle pointed to the PFDI-20’s suitability for postpartum patients, who were included in the dataset. “This particular outcome is a good choice for postpartum patients because it looks directly at 3 symptoms that postpartum patients often suffer from: prolapse, urinary incontinence, and bowel function,” she said, adding that isolating that subgroup could reveal even greater benefit given the barriers postpartum patients face accessing in-person care early on.
Related: Website access blocked for some users
Fewer visits, shorter duration for virtual patients
Virtual patients who achieved clinically meaningful improvement did so with fewer than half the attended visits of in-person patients (mean 6.7 vs 13.8) and in roughly half the care episode duration (116 vs 210 days; both P < 0.0001), according to analysis results.
The findings suggest virtual care could be particularly beneficial for postpartum patients, who often face barriers to in-person treatment.
As a retrospective analysis, the study cannot establish causal relationships between care setting and outcomes, and the virtual group’s smaller size limited statistical power to detect moderate between-group differences.
Miracle disclosed a financial relationship with Origin, the company behind the analysis.
