Resurgence of Telerehabilitation post COVID-19 outbreak

At the start of 2020 we were hugging and wishing everyone and celebrating the New Year being the social animals that humans are!! Little did we know what this year had in store for all of us? And 5 months into the year; there is a state of paranoia and global chaos due to the COVID-19 pandemic. It started like an unknown virus affecting the city of Wuhan in China in early December and has spread around the world like a blazing fire.

In a matter of a few weeks the world has changed and has been forced to adapt to a different method to live and socialise. Handshakes and gatherings are a thing of the past, and are now replaced with a Namaste, group video calls and virtual conferences / webinars.

The most important thing we practice today apart from regularly washing our hands is ‘social distancing’ which is one of the major steps in controlling this pandemic.

Social Distancing

Keeping space between you and others is one of the best tools we have to avoid being exposed to this virus and slowing its spread locally and across the country and the world. Since people can spread the virus before they know they are infected, it is important to stay away from others when possible, even if you-or they-have no symptoms (1).

Social distancing is all the more important for people who are at a higher risk of severe illnesses because of COVID-19 such as the elderly, the immunocompromised and those with pre-existing co-morbidites.

Telerehabilitation

Patients are fearful to visit healthcare setups in the fear of contracting the disease which has lead to a great boom in telehealth care. Prior to this, there was a cloud of apprehension about teleconsultation and telerehabilitation among patients and even some health care professionals were not comfortable and completely convinced about it.

Telerehabilitation can greatly increase access to rehabilitation therapy on a larger scale (3) and this can help in rehabilitating patients during this pandemic.

Cardiac telerehabiltation appears to be at least as effective as centre-based rehabilitation for improving modifiable cardiovascular risk factors and functional capacity, and could enhance rehabilitation utilisation by providing additional options for patients who cannot attend centre-based rehabilitation. The cardiac telerehabiltation practice must now capitalise on technological advances to provide more comprehensive, responsive and interactive interventions (4).

Telerehabilitation program enables patient in saving time and money, and avoiding unnecessary travel and discomfort (5).

According to Forrester Research, telehealth visits can top 1 billion consults by the end of 2020. Analysts and doctors do not expect the “genie of telemedicine to be put back into the bottle” once the crisis ends. “The silver lining is that we will learn how to do it well, and our patients will help us learn how to do it even better” (6).

Given the current landscape of healthcare, physical therapist will have to adapt to remote care now, and in the near future, to stay relevant. To keep up with this trend, physical therapist will need to take constant feedback from patients to continuously modify and amend therapy goals according to the patient’s needs and advancement.

We do not know what happens in the future, but for now telerehabilitation seems like it’s going to stay and be the new norm.

References

(1) https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/social-distancing.html

(2) Klein BC, Busis NA. COVID-19 is catalyzing the adoption of teleneurology. Neurology 2020 Epub Apr 1.

(3) Cramer SC, Dodakian L, Le V, et al. Efficacy of Home-Based Telerehabilitation vs In-Clinic Therapy for Adults After Stroke: A Randomized Clinical Trial. JAMA Neurol 2019;76:1079–1087.

(4) Rawstorn JC, Gant N, Direito A, et al Telehealth exercise-based cardiac rehabilitation: a systematic review and meta-analysis Heart 2016;102:1183–1192.

(5) Peretti A, Amenta F, Tayebati SK, Nittari G, Mahdi SS. Telerehabilitation: Review of the State-of-the-Art and Areas of Application. JMIR Rehabil Assist Technol. 2017;4(2):e7. Published 2017 Jul 21. doi:10.2196/rehab.7511

(6) https://www.washingtonpost.com/health/telemedicine-keeps-doctors-and-patients-connected-at-a-safe-remove/2020/05/14/5f1fa262-742b-11ea-ae50-7148009252e3_story.html

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Rashida Bookwala

Physiotherapist specializing in CardioPulmonary Rehabilitation and Traveller + Gastronome