Myopathies with Contracture: Physical examination of two patients with contractures

The two videos show physical examination of two patients with contractures.  The questions in the PDF file will be answered in the next issue of RRNMF Neuromuscular Journal, along with further discussion as to how to approach a case of muscle contracture and myopathy, as well as teaching points.&nbsp

Physicians Preferences of Virtual Versus In-Person Visits in Neuromuscular Clinical Practice: Telemedicine preference of neuromuscular practitioners

Background: While the role of telemedicine is well established in certain fields of medicine, its role in disciplines like Neuromuscular medicine is not clear. COVID 19 pandemic compelled the medical community to utilize telemedicine and policies were rapidly changed to continue patient care during the pandemic. However, to guide the future of telemedicine in this field where a physical exam is an integral part of the visit, it is imperative to get a physician's opinion on this matter. We designed this study to assess the opinion of neuromuscular physicians about telemedicine, their preference, and factors influencing their decision. Methods: We used an online form composed of eleven questions to survey 94 neuromuscular specialists across the USA and Canada during September 2020. Results:  90.43% of participating neuromuscular specialists preferred physical visits with new patients versus 44.68% preferred physical visits with follow-up patients. The majority thought that telemedicine reduces revenue (58.51%), quality of service (57.45%), and quality time spent with patients (62.77%). Nevertheless, most surveyed physicians agreed that telemedicine is time-efficient (84.04%), improves patient compliance (70.21%), and will be a long-term solution in clinical practice (67.02%). Finally, 58.51% revealed that telemedicine does not affect workload. Conclusion: Neuromuscular specialists preferred seeing new patients and revealing a new diagnosis to the patient in physical visits, but they also considered telemedicine a long-term method that would continue to increase in the post-pandemic future, emphasizing the need to address their concerns to facilitate telemedicine.  &nbsp

Patient preference for virtual versus in-person visits in neuromuscular clinical practice.

Introduction/aimsIt is unknown if patients with neuromuscular diseases prefer in-person or virtual telemedicine visits. We studied patient opinions and preference on virtual versus in-person visits, and the factors influencing such preferences.MethodsTelephone surveys, consisting of 11 questions, of patients from 10 neuromuscular centers were completed.ResultsFive hundred and twenty surveys were completed. Twenty-six percent of respondents preferred virtual visits, while 50% preferred in-person visits. Sixty-four percent reported physical interaction as "very important." For receiving a new diagnosis, 55% preferred in-person vs 35% reporting no preference. Forty percent were concerned about a lack of physical examination vs 20% who were concerned about evaluating vital signs. Eighty four percent reported virtual visits were sufficiently private. Sixty eight percent did not consider expenses a factor in their preference. Although 92% were comfortable with virtual communication technology, 55% preferred video communications, and 19% preferred phone calls. Visit preference was not significantly associated with gender, diagnosis, disease severity, or symptom management. Patients who were concerned about a lack of physical exam or assessment of vitals had significantly higher odds of selecting in-person visits than no preference.DiscussionAlthough neither technology, privacy, nor finance burdened patients in our study, more patients preferred in-person visits than virtual visits and 40% were concerned about a lack of physical examination. Interactions that occur with in-person encounters had high importance for patients, reflecting differences in the perception of the patient-physician relationship between virtual and in-person visits