With the onset of Covid-19 and lockdown in South Africa, telemedicine has come into the forefront. When looking for services offered by physios, speech therapist, and occupational therapists we refer to it is telerehabilitation. You may be wondering but how can I access physio over the phone/ online portal.

WHAT IS TELEHEALTH?

In telehealth we use technology like telecommunication to provide physiotherapy services to patients. Video conferencing is done in real time between a physio and a patient. Telehealth is sometimes referred to as telemedicine, tele-PT or telerehabilitation.

Telehealth was recently approved by the Health Council of South Africa (HPCSA)  for healthcare professionals during the national lock down period, to assist South Africans in the fight against the COVID-19 virus.

Healthcare professionals around the world use telehealth with great success. South Africans are starting to embrace this new form of treatment, because it has many benefits. With HPCSA allowing telehealth during the State of Disaster, the physio society has come on board and we have codes that can be charged by us, and you can claim back from your medical aid (depending on you plan).Some schemes are paying towards the consults and if unsure please contact your funder.

WHAT ARE THE BENEFITS OF PHYSIOTHERAPY IN TELEHEALTH?

• Improve access to physiotherapy service: There are many people in South Africa that do not have access to proper healthcare. Telehealth is a great way to close this gap and provide healthcare to communities that desperately need it. There are also times when accessing in person physiotherapy is challenging e.g. post operatively when you can’t drive.
• Reduce the need for travel: You can do Telehealth in the comfort of your own home or office.  It gives you the flexibility to still do your physio session, whether you have a sick child at home, or caught up with work at the office. It reduces the need to travel, saving you time and money.
• Decrease exposure to infectious diseases: Telehealth is effective to avoid social contact in order to prevent the spread of COVID-19 and other infectious diseases.
• It empowers the patient: Physiotherapy has evolved so much over the years. Focus is shifting from a physio- dependent practice to a patient-empowering practice. Self-treatment techniques empower the patient, making them less dependent on the physiotherapist. Patients need to realize that they can play a big role in treating their own pain. The human body is so amazing that it can heal itself when you do the right exercises and techniques.

HOW CAN PHYSIOTHERAPY BE DONE OVER THE PHONE?

• We start with a subjective evaluation: Just as we would in the rooms we would find out about your injury, when it started, what makes it better or worse. Listening to what bought you to a telerehab consult today. So much of our understanding of what and why things are sore, comes for this initial interview (even in our face to face consult). Understanding how other health problems e.g. high blood pressure and diabetes could impact on what you are experiencing now, and how previous injuries may also impact on your current situation.
• Treatment options: Once we have an understanding of you problem, we can then look at various options.
• Education is important- many times understanding your current situation is a huge first step. Understanding your condition is an empowering first step. It is often a crucial part of treatment in many conditions including osteoarthritis, achilles tendinopathy, and chronic pain (e.g. long-term back pain)
• Self-management techniques- in fact many of you will have done them in our rooms anyway. There are many self-management techniques for many common problems e.g. back and neck pain, knee pain. Ones you may be familiar with are Mckenzie exercises for management of back and neck pain. After all you know your body best, we are here as a coach to help you get the best out of it. In fact, I remember seeing a patient at the gym once and him asking me how to help his back. I gave him an exercise, and now every time he sees me, in congratulates me on putting myself out of business as he hadn’t returned for that injury, as he often manages to sort it out himself.
• Home exercise programs: building a program from the start to the end. We always talk about optimal load- the right amount of load at the right amount of time. We can help you get from an acute injury (sprained ankle, acute back pain), or post surgery (ACL repair, total hip and knee replacement) all the way to getting back to your favourite activity be it running, gardening, or playing with your children and grandchildren.
• Advice on using heat or cold, rest or being active, problem solving alternative positions
• We can still refer on. If after our initial consult we feel you need further investigation we can refer you in the right direction.

ADVANTAGES OF TELEREHAB:

•  We get to problem solve in your own home: In our rooms we have the perfect set up, a step to step up onto, the physio to hold the theraband, the weights easily available. Now we can work out with you where best to do the exercise. We get to problem solve in the real world. This makes it easier for you when you need to do the exercise on your own
• We get to use your equipment and your space.
• We can go through the exercises together: It can be a motivation. We can see where the problems are. In the last few weeks of lockdown many of our consults have been just that, checking in on how an exercise is going, helping to tweak it here and there, offering an alternative. The feedback has been positive.
• Takes place in the comfort of you home: Often when seeing patients post surgery, they need someone to bring them in if they are not able to drive, now that is not needed- you get to stay in the comfort of your own home.

POTENTIAL PROBLEMS:

Technology:

• Data- and internet failures
• Interruption and disconnection of the audio/video link.
• Pictures that are not clear enough to meet the needs of a consultation
• Struggling with technology and programs
• Potential electronic tampering

Privacy and potential hacking:

• We will do everything in our power to maintain confidentiality and meet privacy standards during each session
• To decrease the risk of hacking you can do the following:

– Make use of a known and secure internet connection

– Make sure you are alone during a telehealth consult to increase privacy

– Only make use of secure telehealth platforms

The consult will not be the same as a face to face consult, as we can’t examine you physically. However, we are able to take a complete history and can see how you are moving. We can’t treat you with hand on techniques, but this is only one part of what we do. The consult does have benefits. We look forward to partnering with you on your health journey and hope telerehab may be one of the tools we use. Literally you can give us a call.