I am excited today to share my experience providing physiotherapy services using Healthfx Physiotherapy’s virtual Conferencing platform . As a physiotherapist, this innovative video conference technology allows us to assess and treat individuals from a distance and here is why I am so excited about this opportunity as a growing necessity.
First of all Tele-health Physical therapy is 100% accepted by our licensing body meaning that we are performing all of the requirements that Physical Therapists do which is to conduct an assessment, provide a diagnosis and physiotherapy treatment. I am personally excited about this for our clients because I know it works. There are so many musculoskeletal problems that I have treated successfully over the years using virtual care as the head physiotherapist with Canada basketball, especially leading up to the 2012 and 2016 Olympic Games. During this 8 year period, we successfully treated conditions such as acute back pain, neck pain, knee sprains , hip injuries, and conditions such as rotator cuff tears, plantar fascitis, tendonitis and many other strains and strains. Providing physiotherapy to these olympic athletes was a fabulous experience for me in developing the skills I needed to support them this way.
Now in the social distancing world, being able to provide services remotely has become an absolute necessity. Without a shadow of a doubt, providing my services virtually has been one of the most memorable and rewarding experiences of my 30-year career as a physiotherapist. It’s fun, its efficient but most importantly it is an safe and effective treatment option.
I’d like to describe my experience with providing physiotherapy services at a distance through the lens of one patient.
Let’s call her “Clare.” She is a Chiropractor herself and the first time I connected with Clare, was during the fall just before COVID-19. She had a knee accident with a tear to the ACL ligament and was slotted to have surgery with the Toronto Raptors Orthopedic Surgeon Dr. Paul Marks and her elective surgery was cancelled. We lined up a remote Physical Therapy Session to set up a strengthening program for her to do in her home and she expressed how helpful the session was. At the beginning of our first session, she could see me through her computer sitting in my office and I had access to all of my equpment so that I could demonstrate the exercises to her and modify them accourding to her specific enviornment. Her family were also involved in holding her device and supporting her as we carried out the treatment session.
After she updated me on the previous two weeks, we went through all of the administrative formalities, including informed consent and making sure Claire agreed to being evaluated through Virtual Care. Ahead of our first meeting, Claire had received and filled out the online intake form with her past history details and we reviewed this history just as we would in person. I had actually reviewed these forms and knew a lot about her condition and health history before we even got started, which helped Claire warm up and feel more comfortable with receiving services through Virtual Care.
Claire, who was working as a Chiropractor, gladly discussed with me her condition starting from the date of her injury. As she talked about her job, it was clear we had one thing in common: we both believed we were providing important services to our patients during these challenging times. This session felt like connecting as we would on facebook though we were conducting a consultation meeting virtually.
Chaire told me that until she is able to reschedule her knee surgery, she hopes to be able to develop more leg strength and stay as fit as possible to prepre for this surgery. I explained that we were going to start the examination, so Claire went to a private area of the house where she would be actually performing the exercise program that were to develop. I knew at that point that Claire was comfortable and motivated to carryout the assessment portion and treatment portion of the Virtual Physiotherapy assessment. We were on our way!
At this point, Claire and I stood up, slightly adjusted our camera angles and proceeded with the assessment, which felt the same as it would have in person.This is what happened next - a virtual physical examination including:
- knee range of motion tests,
- tests for swelling,
- observation of painful movements and positions
- observation of function such as stairs, sit to stand, step up, and progressing
- discussion of findings and physiotherapy diagnosis
- discussion of treatment recommendations
- discussion of things to do and things not to do as self care strategies
- review of exercises and techniques as a home program
- answer all questions and provide any resources that are needed
After going through a series of movements, asking more questions and performing some specific tests, Claire and I agreed that her injury had stiffened up her knee and we needed to address her stiffness as well as her weakness. As we discussed the nature of her injury, what to expect in terms of recovery and what she could do to assist with her recovery, including specific exercises I wanted her to do, Claire seemed grateful and appreciative.
Daily Treatment Plan
- 10-15 minutes walking, marching, or cycling to warm up the knee
- 10 minutes heat applied to the knee
- leg slide to full extension with quads contraction hold x 10 seconds
- leg slide into full flexion with a hamstring contraction hold x 10 seconds
- prone assisted knee flexion with opposite foot and hold x 20 seconds x 10
- 3 knee strengthening exercises including squats, backward lunges, loaded step ups
- balance training x 20 march march freeze with 5 second hold
- ice x 10 minutes if any post treatment soreness
Together, we also took some time to review what her return to work process would look like after she had her ACL surgery and how I would be communicating with her surgeon and personal trainer if she needed this help and as we navigate this process, all of which could be done virtually!
Incidentally, Claire also explained to me that a she was concerned that she may not be able to do some of the activites that she was use to doing after surgery so we talked about the research around risk and certain activites. By talking through it, we were able educate her that her conerns were not necessary as she will be able to do what she loves to do very well and with minimal risk. Mission accomplished, Claire was excited about her future and getting started on a more progressive program!
Claire and I have had a couple of follow-up sessions since. We are continuing to progress her exercise program as her subjective and objective examination findings continue to improve. Moreover, Virtual Care allows me to do cool things like sharing my computer screen with Claire during our sessions to show her clips of animated exercise and written descriptions of the type of injury she had.
Claire is still waiting for her surgery but back working full hours and providing much needed support to her patients. Overall, our experience working together using Virtual Care has been incredibly positive.
For more information about Virtual Care, check out our website or call us at (416) 960-4689