COVID rules
Athletes in Connecticut are adapting to new rules of the game amid the coronavirus pandemic.
Though telemedicine has received a huge boost during the COVID- 19 pandemic, you might not think physical therapy would be on that list. After all, the very name suggests something that has to be done in person, with real physical contact between patient and therapist.
But experts said multiple types of physical therapy can be done virtually. In fact, some patients can actually benefit more from having services online — including those at risk for falling, said Myra Odenwaelder, assistant vice president of therapeutic services at Griffin Hospital in Derby.
Video chatting with these patients allows therapists to see their home environments in a way they normally wouldn’t.
“It allows us to make some specific recommendations for fall prevention,” Odenwaelder said.
Other therapists in the region agreed that, while virtual physical therapy isn’t a fit for every patient and all conditions, it’s worked well for many and will likely continue to be incorporated into care long- term.
“I think this is a seminal moment for virtual health care in all settings,” said Mark Parent, physical therapist and area manager for Hartford HealthCare’s rehabilitation network.
Even before the pandemic, he said Hartford Healthcare was incorporating telemedicine into its physical therapy offerings, but COVID- 19 kicked the process into high gear, as it did for telemedicine in nearly every medical discipline.
“Patients couldn’t come to the outpatient setting because of health conditions,” Parent said. “A lot of them elected to discontinue coming to outpatient therapy,” which made it vital to provide those services in another manner.
Vikki Winks, director of rehabilitation services for Yale New Haven and Bridgeport hospitals, recalled getting virtual physical therapy online was something of a trial by fire. She said it soon became apparent there were some people who either didn’t feel comfortable coming for an in- person visit, or were too high risk.
“We just had to start trying ( virtual therapy),” she said. “We hadn’t had any training in it before this. A lot of work went into setting this up very, very quickly.”
Most therapists said there are types of conditions that are more easily converted to virtual physical therapy than others. For instance, speech therapy is considered a good fit for a virtual setting.
“A speech pathologist who needs to work on articulation just needs to be face- to- face with a patient, with no touching,” Winks said.
Odenwaelder said virtual therapy is also good for those who can’t leave work to go to a therapy appointment for a long period of time. “A lot of our patients are essential employees themselves,” she said. “This allowed them to address their rehabilitation needs without leaving work.”
However, there are some conditions that require in- person therapy. Parent said people with lymphedema, a condition that causes swelling in the limbs, need to be treated in- person, because it involves wrapping the patient in compression bandages.
“It’s impossible to do yourself,” Parent said. “It’s very intricate work.”
Certain balance exercises and other physical therapy practices are also best done in person.
If an onsite visit is required, all the therapists interviewed said their practices have taken multiple measures to ensure the safety of patients and staff. These include requiring patients to wear a mask if they are able, making sure all patients are screened before their visit, and emphasizing hand- washing and other similar safety measures.
“We’re very diligent about all this,” Parent said. Winks agreed and said precautions and screening are particularly important because if a physical therapy appointment has to be done in person, it’s likely because direct contact is necessary and social distancing isn’t possible. “We need to make sure our teams are also very aware of what PPE they need to wear,” she said.
But Odenwaelder said many patients can do at least a hybrid of in- person and virtual therapies — with perhaps an initial visit done in person, and follow up done at home.
“There is some benefit to telehealth for most patients,” she said. “I think telehealth will certainly continue to have a place in the rehab space moving forward.”