Covid-19 has provided challenges for many of us, and one of them at our clinic is how to support our clients who are injured when we can’t open for face to face appointments? The answer has been to offer consultations online using video platforms such as Rehab Guru or Zoom, and prescribe rehab exercises.
So how does it work, and can we help if we are not physically in the same room? When working with our clients, the key information is often what you tell us rather than the tests we do. We can ask you to describe your symptoms in detail, and by exploring your pain patterns and how it limits your activity, this gives us a lot of useful information. We can then ask you to perform some movements on the video, which may be similar to tests we would ask you to do in clinic, or may be a functional movement such as a hop. For example, if a client is reporting Achilles tendon pain from running, I will ask them to perform several heel raises on one leg. This will be followed by a discussion of the plan of action, and some suggested rehabilitation exercises. The session will be followed-up by the proposed rehabilitation sent via email and/ or Rehab Guru to save you having to remember the details from the call! This also has the benefit of photos/ videos demonstrating the exercises.
Online consultations or telehealth have been used for a while in physiotherapy circles, and are often used when clients have a long way to travel, are living abroad, or due to work constraints are struggling to book a face-to-face appointment. They are convenient for many people, and have the added bonus of costing less! The use of telehealth is also supported by research, e.g. there is a high level of agreement between telehealth and in-person assessments with respect to diagnosis of musculoskeletal conditions and clinical management decisions (Cottrell et al , 2018), and effective and comparable to face-to-face appointments for the improvement of physical function and pain in a variety of musculoskeletal conditions (Cottrell et al, 2017). I have really enjoyed these appointments, and the online option is something I am hoping to continue with post Covid-19.
Dr Rachel Bevins
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Cottrell et al (2017), Real-time Telerehabilitation for the Treatment of Musculoskeletal Conditions Is Effective and Comparable to Standard Practice: A Systematic Review and Meta-Analysis, Clin Rehabil;31(5):625-638.
Cottrell et al (2018), Agreement Between Telehealth and In-Person Assessment of Patients With Chronic Musculoskeletal Conditions Presenting to an Advanced-Practice Physiotherapy Screening Clinic, Musculoskelet Sci Pract;38:99-105