Before the coronavirus pandemic, many people thought that physical therapy was mostly manual therapy. However, since people are advised to stay at home and avoid non-essential appointments, many physiotherapy patients ended up canceling their in-person treatment and asking for remote physiotherapy.
But is remote healthcare any good? Can telePT be a substitute for in-person physiotherapy sessions? Are mobile health technologies and device rehab worth it? Can patients manage their symptoms without manual therapy and fancy exercise equipment? Well, science has the answers.
Here’s what science has to say
Ascenti, a British physiotherapy provider, studied the effectiveness of remote physiotherapy vs. face-to-face treatment over the course of more than a year. The researchers analyzed the treatment journeys of 27,096 patients, some of whom only had telerehab while others received a mix of in-person and virtual care. A control group of 6,226 patients only had face-to-face sessions with their physiotherapist. The average pain score at the beginning was 5.4.
After analyzing a massive amount of data, here’s what the scientists found out:
- Even people who have never seen their physiotherapist in person experienced significant improvements (by 3.1 points on the Numeric Rating Scale on average)
- Patients with more severe injuries or conditions had more benefits from face-to-face therapy, but virtual-only treatment was still reasonably effective.
- The most effective treatment was a mix of telePT and in-person physiotherapy (pain improved by 3.6 NRS points as compared to 3.4 points in the control group).
- Patients who used their physical therapy app actively and watched exercise videos experienced the biggest improvements.
- 92% of patients were satisfied with teletherapy and 77% were “extremely likely” to recommend it to friends and family.
Ascenti only studied patients who used Ascenti’s own rehab software, but the findings are consistent with other telerehab research studies.
For example, a Dutch study found that “Physiotherapy with telerehabilitation has the potential to increase quality of life, is feasible, and is at least equally effective as usual care in surgical populations.”
A systematic review of randomized control trials found that “Exercise by telerehabilitation may be an alternative to treat pain, physical function and quality of life in adults with physical disabilities when compared with other intervention.”
The findings of these studies confirm that remote physiotherapy is a viable option for outpatient treatment, even when dealing with severe conditions.
What are the main opportunities of digital physiotherapy?
Digital physiotherapy is a wide field that encompasses remote assessment, video and telephone consultations, as well as self-management resources for patients (physical therapy software, exercise videos, advice, progress trackers, elements of gamification etc). While remote physiotherapy cannot fully replicate in-person treatment, it has some unique features that make it a highly effective tool.
First of all: it’s convenient. Patients with busy schedules often struggle to carve out the time for an in-person therapy session because of long commute times, and parents of young children need to arrange childcare before they can actually attend a physio appointment. This can turn physiotherapy sessions into major disruptions, tempting patients to give up quickly.
Thanks to digital health technologies, all they need is 30 minutes of free time. There’s no need to drive anywhere and no need to arrange a caretaker for the kids. This makes telerehab much more convenient, so patients are more likely to complete their entire treatment.
One more advantage of remote physiotherapy is the unparalleled insight into your patients’ daily lives. Let’s say a patient says that she’s been suffering from back pain since she started working from home. During a remote session, you can actually take a look at her home office setup and see if simply adjusting her chair might alleviate the pain.
Thanks to automation, digitized examination and remote monitoring of Raccoon.Recovery, physiotherapists save time that results in up to 150% revenue increase.
Thanks to Raccoon.Recovery you can track your patient’s movements with great precision. When the patient is wearing our wearable devices, you know exactly what movements they do – and whether they’re moving correctly.
Also, some patients in conventional physical therapy tend to believe that you’re treating them and they’re just waiting for the pain to go away. Obviously, this mindset rarely leads to spectacular successes. However, remote therapy helps these patients take responsibility for their own rehabilitation and adopt a different mindset.
Last but not least: remote physiotherapy is so much more than a video call. With modern physical therapy software, patients gain access to a treasure trove of resources: exercise videos, progress trackers, customized tips from the therapist, and much more.
With Raccoon.Recovery, physiotherapy becomes more fun than ever because patients can do their exercise program while playing their favorite video game! The only equipment they need is a set of wearable devices to fix on the affected parts of the body or their own smartphone that can act instead of sensors when fixed properly.
What are the challenges and how to overcome them?
Remote physiotherapy, no matter how technically advanced it is, still has several important challenges to face.
First of all, many physiotherapists rely on their sense of touch. No physical therapy app and no digital tool can replace actually touching the patient to sense the tension of the muscles, to identify pain points and to gain a deep understanding of the patient’s movement patterns.
Not being able to touch your patient means you’re unable to guide their movements and instantly correct any mistakes they’re making in their exercises. If you don’t have access to an advanced telerehab application that captures the patient’s movements using sensors, it will be hard to spot possible mistakes. Instead of practicing healthy movement patterns, the patient might be unwittingly reinforcing the very movement habits that caused their issues – and you won’t be there to guide them.
Patients are well aware of the limitations of remote physiotherapy, so they may feel quite a bit of distrust towards you and your clinical reasoning. They may think along the lines of “How does the therapist know why my arm hurts if he’s never actually seen it?” This lack of trust in teletherapy can greatly reduce patient compliance and jeopardize the success of the entire treatment.
The best way to overcome these potential weaknesses is to combine remote physiotherapy with face-to-face sessions. For example, you could have an initial meeting with a new patient where you go through diagnostic tests and show them their home exercise program. After that, you can rely on the power of remote rehab, especially if you’re using Raccoon.Recovery.
As Toni Muffel put it, Raccoon.Recovery successfully “combin[es] both hardware and software to not only track exercise amount, but also to assess movement quality and immediately provide patients with feedback to their performance”.
Telerehabilitation after the lockdown: What’s next?
Research has shown that digital health solutions like telerehabilitation are more than temporary solutions: they’re effective, convenient, and patients actually enjoy them. Toni Muffel, a researcher at the Max Planck Institute for Human Cognition and Brain Studies, points out that most patients would like to continue remote treatment when the lockdown is over.
The Ascenti study clearly shows that a combination of in-person and remote treatment is the best option for most patients. We believe that this new combination is going to become the new norm in healthcare – especially as telerehab technologies become even more sophisticated and gamification makes remote physiotherapy even more engaging. Device rehab is another important development that you can’t miss out on.
If your facility still doesn’t offer remote rehab on a regular basis, contact us and schedule a free demo of Raccoon.Recovery, our unique rehab software that makes your work easier and your patients happier.