By Deborah Jeanne Sergeant
As with many aspects of life during the COVID-19 pandemic, physical therapy shifted to a virtual model. However, some physical therapy offices are keeping virtual PT as an option for patients.
For Robert Berkley, doctor of physical therapy and owner of Robert Berkley Physical Therapy in Oswego, advantages include the safe, familiar environment of virtual physical therapy.
“The patient feels comfortable in their home,” Berkley said. “They can know they can do their home exercise program because they’re already at home. It’s easy to instruct the patient and not as time consuming as when they come into the office.”
Traveling to and from therapy may be physically difficult for patients already in pain and experiencing deconditioning and limited movement. It’s also tough for patients who lack transportation or whose health makes them unable to drive.
“For a more complex diagnosis, we’d need to see the patient in person, but once they’ve seen a provider with a diagnosis of back pain or weakness, we can treat them virtually,” Berkley said.
Among the drawbacks is the lack of equipment, although creative therapists can usually find ways patients can perform movements with items they have around their homes.
“Sometimes, it’s difficult to instruct patients,” Berkley said. “You can’t put your hands on them to touch and feel.”
Despite this, he believes that virtual physical therapy would be more widely used if more people knew about it.
“Many people aren’t aware it’s available,” he said. “The platform is simple and easy to use.”
Virtual physical therapy can help more people enter and complete physical therapy.
“It’s all about access, like for people without transportation, who have socioeconomic restraints or who live in rural areas,” said Bryan Guzski, doctor of physical therapy and strength and conditioning specialist with Motive Physical Therapy in Brighton, a Rochester suburb. “Virtual services allow us to overcome a lot of those barriers.”
Patients do not need to be in person to discuss their health history and offer an opportunity for a provider to observe their movement. As they squat, lunge, raise their arms and perform other movements — depending on their case — the provider “can get a pretty good picture as to how that person moves and functions,” Guzski said. “There’s an expectation that you need to be right by their side, but a lot of that coaching can be done with visual and verbal feedback from the provider and patient. There’s a lot of value and ways we can help patients.”
Virtual visits also permit providers the chance to see patients’ home environment. They can see how patients move and function in the place where they spend more time than anywhere else. Providers can also observe any obstacles to their activities of daily living, such as a chair that’s hard for them to use and offer suggestions that can help.
“There’s definitely no substitute for getting your hands on the patient, feeling the tissue and joint,” Guzski said. “You can have the patient palpitate, but the feedback is different. The detail and accuracy are different from a trained provider.”
He does see many advantages such as reducing the burden on primary care providers, especially urgent care and emergency rooms, since insured patients can seek physical therapy without a referral in New York and receive treatment for 30 days without a prescription. Most insurance covers virtual physical therapy just as it would in-person physical therapy.