Rehabilitation in the wake of Covid-19 –Top 10 tips for Remote Therapy

As we all embrace the challenges of “Lockdown 3” the SP Therapy Team are calm and coordinated. Our car boots are full of PPE and we have robust risk assessments in place to permit the seamless switch to remote therapy via video link.

Whilst the Government guidelines are that medical appointments can continue many of our patients are in a clinically vulnerable group. They have been working collaboratively with their Occupational Therapists & Physiotherapists to risk assess their individual situation and establish an individualised pathway to continue their rehabilitation and many have chosen to return to remote therapy via video link.

When we faced Lockdown 1 this was a real challenge, something we and the wider rehabilitation world had not done before but the versatility, creativity and can-do approach of the SP Therapy Teams has enabled remote therapy to become a safe, meaningful and realistic approach during these times of adversity. Whilst we all acknowledge it limitations, we have tried to embrace the opportunities it has presented.

1. Accept this is different to face to face.

There is no guidebook so be realistic in your expectations of yourself and your patient

2. Separate the tech from therapy.

Avoid losing the therapeutic relationship due to the strains of technology. Identify a member of your admin team to road test & iron out patients technical issue to ensure they are comfortable & confident.

3. Sort out your space.

This is not a desk task, what does your patient need to see, how will you ensure their view is clear and you can still see them whilst they move. What position do you/they need to be in? What equipment do you/they need?

4. Plan, Prepare & Practice

Know the abilities & limitations of your platform & work around them. For example video yourself doing the task/exercise & watch it with the patient as a baseline for their practice so you can observe rather than demonstrate.

5. Safety First

Plan a virtual of your patients’ home, agree a safe treatment space. Enlist the help of household members support but don’t forget to ensure everyone is ok, check for back pain, give advice on posture or ensure change of position to avoid arm ache from holding the camera.

6. Observe, observe, observe

The focused angle of a camera can allow you to observe in detail, but don’t forget what you can’t see – repeat the task or exercise and change the camera angle or position you will be surprised what you learn. With their consent video the patients performance and let them watch it back and analyse it for themselves.

7. Don’t feel the need to talk all the time

Working remotely is cognitively demanding for the therapist and the patient. The patient is working with less cues than if you were present, give them time to process & respond. Check in with them at the end of the session as to what did & didn’t work, remember this is tough for them too!

8. Record Keeping

Identify in your clinical reasoning what worked and what didn’t & any compromises you made versus face to face. Just because remote is possible does not mean it is preferable to face to face.

9. Diary Management

Schedule an hour per session, but plan on 15 minutes preparation time, 30-minute session time and 15 minutes to write up your notes and plan the next session.

10. Share your success.

The pandemic has provided us as professionals with a unique window to develop tools to assist our patient’s way beyond the restriction of lockdown. There are some fantastic blogs out there & our professional bodies are keen to learn from our experiences in the field.