1 Department of Health, Kinesiology, & Applied Physiology, Concordia University, Montreal, QC, Canada.
2 School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.
3 Trauma Center, Montreal Children's Hospital, McGill University Health Center, Montreal, QC, Canada.
4 School of Health, Concordia University, Montreal, QC, Canada.

Objective: To determine if physiotherapy outcomes differ in children with concussion treated in-clinic versus virtually.

Methods: Licensed physiotherapists assessed and treated 23 children with concussion using telehealth delivery during COVID-19. These patients were matched to children assessed and treated in-clinic before (n = 23) and during (n = 23) the COVID-19 pandemic (total sample mean age = 13.5 ± 3.0 years, 65.2% girls). Physiotherapy examination findings, rehabilitation prescription outcomes, and total recovery time were analyzed using Cochran's Q test, Friedman's tests, linear mixed-effects models, or frailty models.

Results: Missed balance (p < 0.001) and vestibular/visual (p = 0.008) assessments were more frequent in the telehealth group, but no differences were observed for completed assessments (p > 0.05). All participants were given low-to-moderate intensity aerobic exercise recommendations, with coordination (n = 42), vestibular/visual (n = 31), and cervical spine (n = 11) therapies also prescribed. For recovery outcomes, neither the in-clinic (COVID, HR: 0.88, 95% CI: 0.41-1.88, p = 0.74) or telehealth (HR: 0.60, 95% CI: 0.27-1.31, p = 0.20) groups differed from the in-clinic (pre) reference group.

Conclusion: Telehealth delivery produces largely similar outcomes as in-person care, although select assessments cannot be delivered virtually. Telehealth care, particularly hybrid formats, should be further explored for pediatric concussion management.