nerve, combined with stretching exercises, may be equivalent or even preferable to surgery for Carpal Tunnel Syndrome. A 2015 systematic review suggested that while spine manipulation and therapeutic massage are effective interventions for neck pain, electroacupuncture, strain-counterstrain, relaxation massage, heat therapy, and ultrasound therapy are not as effective, and thus not recommended. Studies also show physical therapy is effective for patients with other conditions. A 2012 systematic review about the effectiveness of physiotherapy treatment in asthma patients concluded that physiotherapy treatment may improve quality of life, promote cardiopulmonary fitness and inspiratory pressure, as well as reduce symptoms and medication use. Physical therapy is sometimes provided to patients in the ICU, as early mobilization can help reduce ICU and hospital length of stay and improve long-term functional ability. A 2013 systematic review showed that early progressive mobilization for adult, intubated ICU patients on mechanical ventilation is safe and effective. Results from a 2019 systematic review suggest that psychologically informed physical therapy (PIPT), where a physical therapist treats patients while other members of a multidisciplinary care team help in preoperative planning for patient management of pain and quality of life, helps improve patient outcomes. This is especially present when utilized before and after spine, hip, or knee surgery. Telehealth Telehealth (or telerehabilitation) is a developing form of physical therapy in response to the increasing demand for physical therapy treatment. Telehealth is online communication between the clinician and patient, either live or in pre-recorded sessions with mixed reviews when compared to usual, in-person care. The benefits of telehealth include improved accessibility in remote areas, cost efficiency, and improved convenience for people who are bedridden and home-restricted, or physically disabled. Some considerations for telehealth include: limited evidence to prove effectiveness and compliance more than in-person therapy, licensing and payment policy issues, and compromised privacy. Studies are controversial as to the effectiveness of telehealth in patients with more serious conditions, such as stroke, multiple sclerosis, and lower back pain. During the COVID-19 pandemic, the need for telehealth came to the fore as patients were less able to safely attend in-person, particularly if the were elderly or had chronic diseases. Telehealth was considered to be a proactive step to prevent decline in individuals that could not attend classes. Physical decline in at risk groups is difficult to address or undo later. The platform licensing or development are found to be the most substantial cost in telehealth.