Physical Therapist Impressions of Telehealth and Virtual Reality Needs Amidst a Pandemic

Abstract

Most physical therapists would agree that physical rehabilitation is difficult to perform remotely. Consequently, the global COVID-19 pandemic has forced many physical therapists and their clients to adapt to telehealth, especially with video conferencing. In this article, we ask: How has telehealth for physical rehabilitation evolved with the global pandemic and what are the largest technological needs, treatment methodologies, and patient barriers? With the increased widespread use of telehealth for physical therapy, we present a qualitative study towards examining the shortcomings of current physical therapy mediums and how to steer future virtual reality technologies to promote remote patient evaluation and rehabilitation. We interviewed 130 physical rehabilitation professionals across the United States through video conferencing during the COVID19 pandemic from July—August 2020. Interviews lasted 30–45 min using a semi-structured template developed from an initial pilot of 20 interviews to examine potential barriers, facilitators, and technological needs. Our findings suggest that physical therapists utilizing existing telehealth solutions have lost their ability to feel their patients’ injuries, easily assess range of motion and strength, and freely move about to examine their movements when using telehealth. This makes it difficult to fully evaluate a patient and many feel that they are more of a “life coach” giving advice to a patient rather than a traditional in-person rehabilitation session. The most common solutions that emerged during the interviews include: immersive technologies which allow physical therapists and clients 1) to remotely walk around each other in 3D, 2) enable evidence-based measures, 3) automate documentation, and 4) provider clinical practice operation through the cloud. We conclude with a discussion on opportunities for immersive virtual reality towards telehealth for physical rehabilitation.

Relating visual and pictorial space: Integration of binocular disparity and motion parallax

“…In the meantime, the exponential growth of machine learning and artificial intelligence also provided VR with the tools that make the fabrication of virtual environments and avatars much easier (e.g., realistic virtual environment creation with 3D Gaussian splatting from monocular videos (Kerbl et al, 2023)). Capitalizing on this trend, researchers also reaffirmed their commitment to applying VR technology to transform sectors that are traditionally limited by access to resources, such as medical education and training (Dhar et al, 2023) and physical therapy and rehabilitation (Elor et al, 2022). Perceptually, VR is fundamentally different from vision in the physical environment, where VR simulates visual information through digitally rendered images and presents the images on screens.…”

Wearable: ¿Lujo o Necesidad?

“…El aumento de la carga de lesiones, la dinámica poblacional y la mayor esperanza de vida han hecho que la atención se centre en las altas tasas de discapacidad, dolor crónico y calidad de vida reducida cuando los resultados de los pacientes están por debajo del nivel óptimo. Estas afectaciones se evidencian en todo el transcurso de la vida, por ello a través de los avances en la tecnología, la rehabilitación está aprovechando la capacidad de ir más allá con la esperanza de una recuperación acelerada, estandarizando las evaluaciones y tratamientos buscando reducir la discapacidad 17,18 . Desde esta óptica, la Fisioterapia es reconocida como la primera profesión de la salud comprometida con el tratamiento no invasivo de enfermedades que afectan el movimiento corporal humano 1920,21 y la 21 Reilly C, Sails 20 Dean, E. Exercise Specialists and the Health priorities of the 21st Century: A new perspective on knowledge translation for the Physical Therapist.…”

“…Doi: 10.15446/dyna.v83n197.57588. 17 Owens JG, Rauzi MR, Kittelson A, Graber J, Bade MJ, Johnson J, et al [Internet] Disponible en: https://www.mwtherapy.com/blog/6-new-technology-trends-in-physical-therapy-in-2022 15 12 Equipo de Expertos de Ciencia y Tecnología de la Universidad Internacional de Valencia. Qué es wearable y qué tipos de dispositivos existen.…”

Feasibility of Timed Up and Go Administered via Telerehabilitation in Older Adults

“…Studies support the utilization of telerehabilitation in improving outcomes such as pain, activities of daily living, balance, quality of life, and exercise capacity 1. This alternative mode to in-person services helped sustain the continuous need of the community for physical therapy during the COVID-19 pandemic 2. Changes in payor policies and state laws facilitated the rapid adoption of telerehabilitation to allow continuity of care such as physical therapy in the convenience and safety of patients' homes during social isolation 3…”

“…1 This alternative mode to in-person services helped sustain the continuous need of the community for physical therapy during the COVID-19 pandemic. 2 Changes in payor policies and state laws facilitated the rapid adoption of telerehabilitation to allow continuity of care such as physical therapy in the convenience and safety of patients' homes during social isolation. 3 It is expected that the availability of health care services that are delivered virtually will continue to grow.…”