Physical therapy during COVID-19
Physical therapy is normally a very hands-on type of treatment, making it seem like an unlikely choice for telehealth appointments. But while they are not as ideal as an in person visit, they are a great option for certain patients during this time of keeping a safe distance. Last week the Cape Cod Hospital Rehabilitation Services and their three satellite clinics began to schedule telehealth visits.
“There are a lot of things we can do,” said Director of Rehabilitation Services Julie Drake, PT, DPT. “We can’t do specific strength testing and we can’t do any manual therapy, obviously, so our therapists are doing function-based activities, like sit to stand and postural exercises. They are instructing patients in gait training exercises, core strengthening, shoulder exercises and leg strengthening. If people have TheraBands or weights at home we can advise them on how to use those.”
Telehealth appointments would be appropriate for those with chronic issues like back pain, neck pain, balance problems, orthopedic issues, or general deconditioning, she said. They would also work well for patients who are already familiar with physical therapy because they may already have had some education about movement and what some appropriate exercises may be for them and how to do them safely.
In addition to physical therapists, occupational therapists and speech therapists are also doing telehealth appointments.
“An occupational therapist would be primarily looking at activities of daily living with people in their homes,” Drake said. “Again, it’s more function-based activities and maybe suggesting modifications to their home environment to help make it easier for them to perform their activities of daily living, whether it’s cooking, feeding, bathing or dressing.”
Our speech and language pathologists are also finding it very effective to provide telehealth visits for their patients, particularly for the pediatric patients. They can continue with their therapy while remaining safe in their home environment.
For patients who are appropriate for telehealth visits, Drake offers this suggestion for success: Make sure you are in a well-lit room with plenty of space to do the actual exercises.
The clinic has been set up for the physical therapists to have a separate office space to do the visits, in order to ensure patient privacy. The office space has good lighting and is large enough for the physical therapists to be able to demonstrate the exercises, Drake said.
At this time, AllWays Health Partners insurance is the only insurance that does not cover telehealth visits, but Medicare and most other private insurance companies do.
Some patients, like those who have just had surgery, those with acute injuries or those whose conditions would regress without it, still need to do physical therapy in person. For those patients, Rehabilitation Services at Cape Cod Hospital are open at all three of their outpatient locations at Attucks Lane in Hyannis, Old Colony Way in Orleans and Main Street in Chatham.
“We’re screening everyone,” Drake said. “We have a questionnaire that we have each patient fill out on arrival. We take their temperature and we give them a mask, and all of the staff have to do the same. They all have to sign in and answer the same screening questions about fever and cough and exposure and they wear the PPE as well.”
Patients need to call to be screened for an appointment to see if it would be appropriate to come into the clinic, she said. Some patients will be evaluated in person for their initial visit and then switch to telehealth visits. Others will do telehealth visits, exclusively.
“We will decide what the best and safest option is for the patient based on our screening questions,” she said.