- Caleb Coe
Why Virtual Rehab Is the Future
Virtual rehab is new and may raise some concerns for you and that is totally understandable. The goal of this article is to explain my rationale as to why I believe it is the best move forward and let you decide for yourself. So hang on tight, we are going to solve all the worlds problems in the next 8 minutes.
FREQUENCY IS KING
When it comes to rehab frequency is king. The more frequently you are able to rehab the quicker you will get better and the better results you will be able to get. There is no question about that. We also must acknowledge that nothing in the human body works in isolation - everything is connected and as such, a shoulder injury may also need to work on their ribs and pelvis. We also can not neglect other factors outside of the musculoskeletal system. Sleep, diet, stress, work, etc can all play a factor in our ability to heal and our rehab outcomes.
With all of the above in mind, do you think going to therapy 1-2x per week for 30-45 minutes is a sufficient amount of time to create real change in all of these categories? Not at all. Not to mention, things like sleep, stress, or nutrition are rarely discussed or implemented. By rehabbing virtually, you can rehab 5-7x per week without a significant price increase (probably a price decrease depending on your insurance). This allows us the time to
CONVENIENCE IS QUEEN
Guess what the number one factor in determining the success of rehab? The proximity of the patients house to the clinic. The closer people live to the clinic the greater chance that they would have a good response to therapy. People value convenience. Instead of having to go out of your way to go to the physical therapy clinic we integrate it into your life. Your rehab is delivered to your phone, your therapist is a text or zoom call away, your clinic is your home or local gym.
MONEY IS PRINCE
Money matters. Let's just assume you have insurance that covers rehab and you don't have a high deductible plan. The average co-pay cost is $20-50 per visit and they typically allow for 30 therapy visits in a year. If you believe that frequency is king (it is, see above) that can get pretty pricey quickly even though it is covered. In our model, you are able to have 3-5 rehab sessions per week for $200/month and 5-7 rehab sessions per week for $400/month. This allows us to keep the prices reasonable while also allowing you to rehab at a high frequency.
IT WORKS
One of the first concerns I had initially (as well as you I am sure) was will I still be able to get good results virtually? The short answer is YES! More and more research is showing that telerehab is just as effective as in person rehab. You may be asking, "how is that possible? They aren't able to poke and prod me." While that is true, we are not able to feel soft tissues virtually, research is showing that despite the inability to poke and prod the management doesn't change. We pick the same exercises, educate the same, guide the same, just over a zoom call vs in-person.
AUTONOMY
Our job as physical therapists is to guide not hand hold. If you want to get better YOU are going to have to put the work in. There is nothing more rewarding than giving a patient the tools and a gentle shove in the right direction and watching them do the rest. I think it is incredibly empowering to give patients the autonomy and control over their own rehab vs just holding their hand every step of the way.
MANUAL THERAPY
You may be wondering, "What about manual therapy or massage? You can't do that virtually." You might be surprised. While manual therapy can be beneficial in providing short term changes in pain or range of motion, these changes are often short lived and can be achieved with different interventions. For instance, foam rollers, lacrosse balls, massage guns are all things that could provide similar benefits as any hands on treatment I could provide.
There we have it folks. All the worlds problems solved in 8 minutes. Virtual rehab is the future! It has been shown to be effective, affordable, convenient, and just better! If this sounds like something you are interested in but you still have questions please feel free to book a FREE Discovery Call at the link below. This allows us to better get to know each other and see if we are a good fit for you!
https://secure.gethealthie.com/appointments/embed_appt?dietitian_id=1584033
TELEREHAB REFERENCES:
Fernandes LG, Devan H, Fioratti I, Kamper SJ, Williams CM, Saragiotto BT. At my own pace, space, and place: a systematic review of qualitative studies of enablers and barriers to telehealth interventions for people with chronic pain. Pain. 2022;163(2):e165-e181. doi:10.1097/j.pain.0000000000002364
Cottrell MA, Galea OA, O'Leary SP, Hill AJ, Russell TG. Real-time telerehabilitation for the treatment of musculoskeletal conditions is effective and comparable to standard practice: a systematic review and meta-analysis. Clin Rehabil. 2017;31(5):625-638. doi:10.1177/0269215516645148
Cottrell MA, O'Leary SP, Raymer M, Hill AJ, Comans T, Russell TG. Does telerehabilitation result in inferior clinical outcomes compared with in-person care for the management of chronic musculoskeletal spinal conditions in the tertiary hospital setting? A non-randomised pilot clinical trial. J Telemed Telecare. 2021;27(7):444-452. doi:10.1177/1357633X19887265
Bucki FM, Clay MB, Tobiczyk H, Green BN. Scoping Review of Telehealth for Musculoskeletal Disorders: Applications for the COVID-19 Pandemic. J Manipulative Physiol Ther. 2021;44(7):558-565. doi:10.1016/j.jmpt.2021.12.003
Bennell KL, Marshall CJ, Dobson F, Kasza J, Lonsdale C, Hinman RS. Does a Web-Based Exercise Programming System Improve Home Exercise Adherence for People With Musculoskeletal Conditions?: A Randomized Controlled Trial. Am J Phys Med Rehabil. 2019;98(10):850-858. doi:10.1097/PHM.0000000000001204
Koppenaal T, Pisters M, Kloek C, Arensman R, Ostelo R, Veenhof C. The 3-Month Effectiveness of a Stratified Blended Physiotherapy Intervention in Patients With Nonspecific Low Back Pain: Cluster Randomized Controlled Trial. J Med Internet Res 2022;24(2):e31675. DOI: 10.2196/31675
Seron P, Oliveros MJ, Gutierrez-Arias R, et al. Effectiveness of Telerehabilitation in Physical Therapy: A Rapid Overview. Phys Ther. 2021;101(6):pzab053. doi:10.1093/ptj/pzab053
Lorig KR, Ritter PL, Laurent DD, Plant K. The internet-based arthritis self-management program: a one-year randomized trial for patients with arthritis or fibromyalgia. Arthritis Rheum. 2008;59(7):1009-1017. doi:10.1002/art.23817
Hinman RS, Nelligan RK, Bennell KL, Delany C. "Sounds a Bit Crazy, But It Was Almost More Personal:" A Qualitative Study of Patient and Clinician Experiences of Physical Therapist-Prescribed Exercise For Knee Osteoarthritis Via Skype. Arthritis Care Res (Hoboken). 2017;69(12):1834-1844. doi:10.1002/acr.23218
Lawford BJ, Delany C, Bennell KL, Hinman RS. "I was really sceptical...But it worked really well": a qualitative study of patient perceptions of telephone-delivered exercise therapy by physiotherapists for people with knee osteoarthritis. Osteoarthritis Cartilage. 2018;26(6):741-750. doi:10.1016/j.joca.2018.02.909