Physical therapists wear many hats. We’re educators, thinkers, problem solvers, and motivators. We’re creative and have to be able to think outside of the box on a daily basis in order to work with the layered human body. These are qualities that come in handy when options become limited. Six weeks ago, the prior 20 years I spent working as a physical therapist in various healthcare settings amounted to many valuable experiences, but none of them included exposure to telehealth for the delivery of physical therapy (PT) services. Five weeks ago, along with so many others, myself and my colleagues at Evolution PT & Yoga were launched into a new working atmosphere due to COVID-19. In our world of healthcare, this meant joining the world of telehealth (also known as telemedicine) to bridge the gap between clinical care and homebound recommendations.
Telemedicine has been in existence in various forms since the late 1800s, including making diagnosis over radio waves or use of the telephone to reduce unnecessary medical office visits. In the late 1990s, along with the birth of the internet, telehealth really began to take shape. Since then, while telehealth’s reach has expanded significantly, it’s access and delivery for specific disciplines and clients has varied state to state. In Vermont, physical therapy telehealth services had not been covered by health insurance companies with the exception of Medicaid, which offered partial coverage and reimbursement.
Fast forward to present day 2020 and COVID-19 and it’s easy to see how telehealth is the wave of our future. Due to the expedient work of Vermont State legislators in mid-March of this year, comprehensive telehealth PT care and full coverage and reimbursement were made immediately accessible through all insurance companies with the considerable exception of one: Medicare.
This change in accessibility broadens the options available for people seeking PT care. Assessments and many diagnoses can be made and easily addressed via telehealth PT through patient education and direct observation in a person’s specific environment. For example, new-onset neck, shoulder, or back pain due to sitting in unusual positions on your home furniture, which was never intended to be your office furniture, can be addressed.
Appropriate exercises, stretches, posture modifications, and other interventions can be taught and reviewed with accuracy in the space and with the equipment available to each client in their home. And the technology really is easy to use if you have a reliable internet connection and a device such as a smartphone, tablet or laptop.
Steady support systems and education are imperative to establish and keep in place for many individuals, and clients seeking PT to address persistent pain and chronic issues are no exception. In this way telehealth can also be extremely effective. Strategies to help calm and balance the nervous system, for example guided relaxation and breathing practices, can help to optimize the function of all the other systems in our bodies and can be just as effective as when they’re delivered in the clinic. Aspects of yoga can also be integrated on an individual client basis as effective tools in managing challenges and working toward a more balanced state of health.
Like anything, telehealth PT has its limitations; mostly that the skillful hands-on work we practice in a clinical setting can’t be directly integrated from therapist to client in a telehealth session. However, in some specific cases where individuals would benefit most from hands-on work, we can guide them through different self-directed manual tissue techniques for the feet, legs, wrists, elbows, and forearms to name a few.
Telehealth PT offers a safe and convenient alternative to in-person visits for those facing limitations being able to leave their home whether it’s due to health-related concerns, childcare issues, or anything in between. More and more this option is imperative as we navigate our way as a community through these unprecedented transitions over the upcoming months. If you or someone you know is seeking PT or has questions about what PT telehealth can do for your specific needs, please contact Evolution PT by phone (802) 864-9642 x10 and leave a message that will be returned by the following business day or email In addition, daily yoga classes, workshops, and series are offered and free breathing and meditation sessions are offered on the schedule daily.
We thank you for your continued support and look forward to seeing you either on screen or off when the time comes. Until then, be safe, be healthy and be steady.
1 The Evolution of Telehealth: Where Have We Been and Where Are We Going?Thomas S. Nesbitt, M.D., M.P.H. University of California, Davis, Health System

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