Liz Miracle, PT, MPT, WCS, explains comparable outcomes in virtual pelvic care

Virtual pelvic health physical therapy produced outcomes comparable to in-person and hybrid care in a retrospective analysis of 4,662 female patients, according to Liz Miracle, PT, MPT, WCS, pelvic floor physical therapist board-certified in pelvic and women's health, and Head of Clinical Quality, Origin, a clinician involved in the white paper analysis.

“What we learned was that of the patients that came to Origin, they had comparable outcomes across 3 different care settings: virtual care, hybrid care, which is where we have patients who are doing both a plan of care that is virtual and in person, and then in-person care settings,” she said.

“The important thing about this was that this paper observed that there was no signal that in-person care produced better outcomes than virtual,” Miracle said.

According to the white paper published by Origin, the cohort comprised 2833 in-person, 1536 hybrid, and 293 virtual patients treated between June 2022 and June 2024. The majority in all 3 settings achieved clinically meaningful improvement (MCID) on the Pelvic Floor Distress Inventory-20 (PFDI-20), and no pairwise between-group comparison reached Bonferroni-corrected significance (required threshold P < 0.0167).¹

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.

Virtual patients who achieved MCID 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.

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.

Editor’s note: Liz Miracle reports a relevant disclosure to Origin.

Reference:

Link A, Worman R, Kavassalis N, Miracle L. Expanding access, maintaining outcomes: virtual, in-person, and hybrid pelvic health care in a retrospective cohort of 4,662 patients treated at Origin. Origin. 2026. Accessed August 7, 2026. https://www.theoriginway.com/2026-outcomes-white-paper