The COVID-19 pandemic has compelled many physical therapists to pivot to virtual healthcare. As a result, virtual physical therapy, also known as “telehealth physical therapy,” is rapidly growing, allowing many patients to experience online PT appointments for the first time. In this post, we define virtual physical therapy, explain how it works, and discuss some of its advantages over in-person visits.
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What Is Telehealth Physical Therapy?
The term “virtual healthcare” refers to clinicians providing services to patients via communications technology. For example, a doctor can videoconference a patient who is at home.
Instead of traveling to a clinic for an in-person visit, patients communicate with a physical therapist via phone call or videoconference and attend the appointment from home.
Telehealth is used across different physical therapy specialties, and may be a fit for patients who will benefit from appointments in which physical touch from the PT is not required. For example, virtual sessions can be used to help educate patients. Telehealth physical therapy can also compliment in-person sessions.
Is Virtual Physical Therapy Effective?
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Research has shown that, for certain treatments, virtual physical therapy is equally effective as in-person therapy.
A study published in The Journal of Bone and Joint Surgery showed that telerehabilitation was similarly effective as traditional care for patients recovering from total knee arthroplasty.
The Musculoskeletal Journal of Hospital for Special Surgery discovered that, during COVID-19, patient satisfaction with virtual physical therapy was comparable to patient satisfaction with in-person services.
Benefits of Virtual Physical Therapy
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While different from traditional services, telehealth physical therapy has its upsides. In this section, we expand on several key benefits.
Illustration of the three main advantages of virtual physical therapy: accessibility, patient independence, and time-saving.
1. Accessible to More Patients
A huge benefit of virtual physical therapy is that it is accessible to more people. For those who live in rural areas far from the nearest PT clinic—or who don’t have ready access to transportation—attending online sessions may be considerably more feasible than traveling to in-person appointments.
Virtual physical therapy is also more accessible and comfortable for rehabilitation patients. While recovering from surgery or injury, a patient may be unable to drive to an appointment. Telehealth therapy allows them to make progress on their recovery without needing to leave home.
2. Helps Patients Independently Manage Symptoms
Allowing patients to self-manage their symptoms in their own homes can grant them a greater sense of independence, making them feel more in control of their recovery process. It may also be helpful to conduct virtual sessions in the same area of the home where patients will be practicing exercises on their own. That way, the physical therapist can provide guidance on using rehabilitative equipment and features of the home (such as walls, doorways, and furniture) within certain exercises.
3. Saves Time
Virtual physical therapy sessions may be easier for patients to fit into their busy lives, since they don’t have to drive to the PT clinic. For parents and those with demanding work schedules, an at-home appointment can offer a welcome level of convenience.
What to Expect from a Virtual Physical Therapy Session
A woman on her laptop looks at an image of a physical therapist massaging a patient’s lower back.
As a patient, you will need a computer, phone, or tablet for your virtual appointment. Your physical therapist may contact you ahead of time asking you to download the appropriate videoconferencing platform. Before the session, make sure you have a reliable Internet connection and a space in your home with room for you to move. Position your device’s camera so that your PT can see all your movements.
During the session, your physical therapist may verbally guide your exercises, perform the exercises with you, observe your movements, look for any difficulty of movement, and engage in discussion. In some cases, they may ask you to use furniture, walls, or basic household items to perform exercises or aid in balance.
What Makes a Successful Session?
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It’s the job of a physical therapist to help patients regain their range of motion, manage pain, and improve their quality of life. Even when the session is virtual, your PT should deliver excellent care. During a successful session, your PT should express compassion, communicate clearly, and encourage questions. They will work with you to make a plan, set realistic goals, and help you work toward them.
If you’re interested in virtual physical therapy, contact your PT to create an individualized plan and discuss whether you are a good candidate for virtual sessions.
Not only can virtual physical therapy be highly effective, it offers a host of other benefits that may surprise you. Online physical therapy:
Furthers patients’ independence.
“Virtual physical therapy actually encompasses the core of what we do as clinicians that is, further our patients’ independence by enabling them to self-manage their symptoms and the progression of therapeutic activities in their home environment,” says Dr. Janelle Giresi. “Exercise prescription and movement analysis is our expertise as physical therapists, and we can do this very effectively through telehealth.”
Highlights how much progress can be made at home.
“Patients often don’t realize how much they can achieve by following an individualized plan of care at home,” says Dr. Michael Lampman. “A silver lining of having to stay at home is that patients are seeing how much progress they can make and are also gaining confidence in their ability to advance their functionality mobility, even when they’re not in the gym with their therapist. Many patients who were first skeptical of virtual physical therapy sessions are now loving them – and the progress they are making.
Benefits
Reduces stress and improves respiratory health
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“It’s more important than ever to stay physically active during this difficult time,” says Dr. Lampman. “Moving and exercising – including physical therapy – can reduce overall stress levels, improve respiratory status and improve overall health.” “Don’t forget that physical activity causes the release of endorphins, which are the ‘feel good’ hormones that boost your mood and general health,” Dr. Giresi adds.
Helps increase the effectiveness of at-home workouts
While patients are provided an individualized plan of care regardless of where therapy takes place, the personalized recommendations for effective at-home exercises are especially valuable while gyms are closed and as online workouts generally cater to the masses. “Always reach out to your physical therapist if you’re in need of ideas for new exercises,” says Dr. Marceca. “We’re here to help!”
Strengthens the immune system
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“Human connection strengthens the immune system, and while social distancing measures are in place, online physical therapy visits provide patients another avenue to connect with a partner who is not only supportive of their physical health … but also of their general wellbeing,” Dr. Lampman notes.
Lisa Sandberg fractured her elbow in early April while on a walk with her husband. Following the injury, she needed help regaining strength, function, and range of motion in her arm. So she called Reena Sehgal, a physical therapist she’d used in the past. But rather than go to her in person — an impossibility during the coronavirus pandemic — the two women have been working together virtually for about an hour two times a week.
You may be wondering how physical therapy, which tends to require touching, stretching, manipulating, and putting pressure on someone’s joints and muscles, can take place via telemedicine, using a digital device such as a computer or smartphone. It’s a valid question, and something those in the industry have wondered about themselves.
On-Screen Assessments and Exercise Instruction Prove Doable
“At first, seeing patients virtually felt like roller-skating for the first time with your hands tied behind your back,” says Eric Robertson, a board-certified clinical specialist in orthopedic physical therapy and professor at the University of Southern California division of biokinesiology and physical therapy in Los Angeles and a spokesperson for the American Physical Therapy Association (APTA).
“I was very uneasy and saw challenges at every level. However, I quickly gained a vocabulary and set of assessment tools to efficiently assess patients. In other words, it was much easier than expected to apply the skills of physical therapy into this new environment,” Dr. Robertson says.
It helps that physical therapy isn’t just about touch. It often involves a lot of analysis of a person’s movements, followed by helping them do exercises.
Sandberg, a marketing executive in her fifties who lives in Princeton Junction, New Jersey, says her experience with remote physical therapy was pretty straightforward. “Reena usually sends me some exercises in advance with little video clips so that I can get an idea of the type of exercises,” she says. “Then when I get on the session with her on camera, she goes over the exercises with me and watches me as I do them, and she’ll often do them at the same time as I do.”
How to Prepare for a Virtual Doctor Visit
Studies have demonstrated physical teletherapy’s efficacy. A report published in January 2020 in The Journal of Bone & Joint Surgery studied 287 people with a mean age of 65 who had undergone total knee replacement surgery. Half did in-office or at-home physical therapy, while the other half used the Virtual Exercise Rehabilitation Assistant (VERA) system, which uses 3D technology and a digitally simulated instructor to give exercise instructions and provide immediate feedback based on a user’s movements. The virtual PT group also received weekly telehealth visits with a live physical therapist, who created individualized therapy programs.
According to the report, those who used the VERA system were hospitalized less and able to be physically active more than those who used traditional physical therapy.
Remote Physical Therapy Becoming More Accessible
The Centers for Medicare and Medicaid Services is now allowing physical therapists in private practice to bill for their face-to-face technology visits. Various insurance companies have started covering physical therapy delivered via telehealth.
“It’s been a very quick and easy learning curve on both ends,” says Karen Litzy, a physical therapist in New York City who is also an APTA spokesperson. Dr. Litzy, whose patients range in age from 10 to 70, has used the Zoom platform for PT appointments since the coronavirus lockdowns began.
Much of her work involves watching the way people move and looking for faulty movement patterns or movement that exacerbates their symptoms, like pain, numbness, or tingling.
“Then the biggest thing we do is we create individualized exercise programs for those clients to do while we’re there and also on their own,” Litzy says.
Physical Therapy Is Helping COVID-19 Patients Heal
In addition to her regular clients, Litzy has been seeing a lot of people who are physically weak after being sick with COVID-19. Many had been hospitalized; others spent a lot of time in bed. She expects physical therapy to play a huge role in helping people overcome their post-COVID-19 ailments, which can impair their ability to move freely and walk, especially if they’ve been lying in bed for weeks or months.
“I think telemedicine is going to be a great new adjunct for the future,” she says. “I really think telehealth is showing PTs and all medical professionals what’s really important when it comes to patient outcomes and treating patients.” It’s also allowing people in rural areas, who often have to drive hours to reach a clinic, the ability to see a professional remotely.
What You Need for a Virtual PT Visit
So what’s needed for successful virtual physical therapy? According to Litzy, just a few basic items:
A good internet connection
Space to lie down, walk, stretch, and turn around, so your therapist can see how your body moves
Good lighting
“We try to figure out the best camera angles,” says Litzy. “Once we figure out the layout of their place and the camera angles, it’s that much easier.”
For Sandberg, it’s been simple. Before hurting her elbow, she had started online physical therapy sessions for a herniated disk. “Reena had me on my Pilates reformer in my house and was working with me on exercises both on and off that machine,” she says. “It’s not so weird not having her touch me, because for this particular injury there’s no manipulation needed. She just needs to guide me through doing the exercises in the proper form. I can see her clearly on the computer screen and hear her well, so we haven’t had any technical difficulties. Most sessions consist of discussion of my flexibility and pain and ease of movement, and then we get into exercises and instruction on what to do until the next time.”
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