Can you use telehealth to deliver physical therapy?

Physical therapy is considered to be an entirely hands-on profession, so for quite a while, it seemed as though it would not be affected by the evolution of telehealth services. The remote delivery of physical therapy services has been largely met with skepticism, both on the part of those in the profession and those receiving services. Until I actually started practicing this way, I was a skeptic myself. I have been a telehealth provider for three years, and I have seen the results that this modality can produce. With the current Covid-19 crisis and subsequent closures of many clinics, I decided to expand my platform in order to create access for clients who are no longer able to have in-person visits.

Three years ago, when presented with the opportunity to deliver telehealth services, I wondered, “How is this going to work? What am I actually going to do?”

I soon found the answer to these questions. I realized that “I’m just doing what I always do.” I am watching my clients move through their environments and assessing where they are having difficulties. I once had a mentor tell me, “You can find out everything you need to know through the patient’s story. You can see how they are sitting in the waiting room, and how they walk to the exam room. You should have a diagnosis in mind before you ever touch them.”

Whether working with children who have gross motor delays or adults with joint pain, I have found that I learn what I need to know to help them through interviews and observations of movement. I can then prescribe exercises to be done to address motor dysfunction, and make activity recommendations for appropriate exercise routines or how to remain safely mobile in their home, school, or job.

The added bonus of teletherapy services is that the client can remain in a familiar environment where he will likely perform most of his independent exercise program. Further, it allows for flexible scheduling around a work or school day and eliminates the inconvenience of a commute to a clinic. Families do not have to secure child care or transportation in order to participate in therapy. As has been illustrated by recent events, it also creates a safe environment for those who are immunocompromised to exercise with the supervision of a trained professional without risking exposure to illness.

We have created access, consistency, and a therapeutic setting. What we truly want to know is: does it work?

The answer is, yes. It works, and I have seen this firsthand.

 One particular client comes to mind. Jane* is a woman in her early thirties with two children under age two. She had onset of severe back pain after lifting her daughter one evening, and had not been able to recover despite her best efforts with stretching, gentle yoga, and walking. Jane is also a teacher, so she rarely has time to schedule an appointment during traditional clinic hours.

When I first saw Jane via telehealth, she was in tears from discomfort. I performed a subjective interview and ruled out any potential for a medical cause to her problem. I was able to give her exercises to do that would afford relief, based on my visual assessment of her movement. I prescribed a home exercise program and advised her to follow up in 2 weeks.

By the time of her follow up, she had nearly total relief from her back pain. She was able to return to yoga and caring for her two young children without limitation by back pain.

So, when I tell people I work as a telehealth physical therapist and am inevitably asked, “So, how do you do that?” I say, “I do what I always do. It’s just from a further distance than usual.”

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