Navigating Your First Telehealth PT Visit

I wasn’t completely sold on the idea of telehealth physical therapy at first. There is so much that we are able to do with our hands and physically being with the person guiding them through exercises. However, what I have come to learn is that physical therapists have the knowledge to help people and improve quality of life without being there physically! A study done this year by the Hospital for Special Surgery determined similar patient satisfaction between in-person vs. telehealth PT visits during the Covid 19 crisis. At least during the times when in-person services may not be available fully during the pandemic, telehealth seems like a viable stop gap until we can get back to normal operations as an industry. This is a relatively new option for both clinicians and patients. In this post, I will walk you through a typical scenario of a patient presenting for a telehealth evaluation, and try to answer some questions that commonly come up.

What does a telehealth physical therapy evaluation look like?

A lot of what is done in a typical in-person evaluation can also be done through telehealth. The therapist will take a thorough history of the current problem. Other things that are reviewed while collecting information include: 

Description of pain

Relevant past medical history and medications

Functional limitations – what activities you are currently having trouble with?

What have you done to this point treatment wise?

Have you seen anyone else for this problem?

What are your goals for physical therapy?

Once all subjective information has been gathered, the therapist will conduct movement screenings with the patient to visualize movement patterns and range of motion. There might be specific tests or more general tasks like “point to where the pain is” or “show me how you squat.” Some movements that can be observed are:

Gross joint range of motion

Squatting, lunging

Balance on toe feet or one foot

Touching your toes

Raising your arms overhead

Turning the head side to side

Ankle circles

Raising up onto your toes

Laying on your back and bringing the knee to chest

Things like this are visualized in order to give the therapist cues on where in the movement could be improved to reduce pain. There are more specific tests that could be done based on the patient’s symptoms. These are just some examples so you can see what kind of tasks are performed to complete a full evaluation on telehealth.

Once all of the tests and measures are completed, the therapist will assess your situation and give feedback regarding:

Differential diagnosis

Factors that are contributing to the problem

Modifications the can help the problem

Determining whether or not further referral is warranted 

Usually, the therapist can get right into trying out coaching some exercises and activities on the first day. Some interventions that can be completed via telehealth include:

Anatomical discussion of the patient’s problem

Ergonomic evaluation of workspace

Discussion of home layout for fall prevention

Sleep position discussion

Discussion of making time for physical activity

Possibly avoiding aggravating activities temporarily

Figuring out how to ramp up back to prior activities pain free

Prescription and execution of exercise program including mobility, correctives, strength training, functional activity specific exercises

Modification of current exercise program including type of exercise, volume, intensity, and duration 

As you can see, a lot can be accomplished with a physical therapist online! Most of this was rarely used or unheard of even a year ago, and yet here we are helping people through brand new mediums. Now, if you have a telehealth physical therapy appointment, how do you best prepare for your visit?

Here are some tips to optimize the success of your telehealth PT:

Do a test run of the platform (whether it’s Zoom, Google, or another program) to make sure that you can log in and the system works on your computer.

Complete any intake paperwork online before the visit if required.

Set up in a room that has the most floor space, and have a mat ready on the floor if possible. You want to set up your device so that you can be seen moving around. 

Dress in clothes you can move around in. You want to be comfortable.

Have your home exercise equipment available or make a list of what you have. This will help the therapist because they will know what equipment they can use when writing a program for you.

Make sure the room is well lit so that the therapist can see you.

Try to eliminate distraction as much as possible – this includes other devices, pets, or other people talking in the background during the session. Remove anything in the room that you can possibly trip over.

Most importantly…ask questions! This is a new experience for most so questions are welcomed.

I hope that this helped show the benefit seeing a physical therapist on a screen. It may sound strange, but these are strange times. Telehealth will probably not remain as such a high percentage of the physical therapy industry once the pandemic is over, but definitely has now become another tool that we can utilize if the patient scenario fits. If you have any more questions, follow the Schedule Now link on the home page and get your complimentary telehealth consult!

Stay safe, everyone.

 

Works Cited:

Eannucci, E.F., Hazel, K., Grundstein, M.J. et al.Patient Satisfaction for Telehealth Physical Therapy Services Was Comparable to that of In-Person Services During the COVID-19 Pandemic. HSS Jrnl (2020)

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