The Implementation of Teleconsultations in a Physiotherapy Service During COVID-19 Pandemic in Brazil: A Case Report

Abstract

Introduction: The Brazilian Council of Physiotherapy and Occupational Therapy regulated the use of teleconsultation during the COVID-19 pandemic, creating uncertainty about its use in Brazil. Objective: To describe the experience of teleconsultations during the COVID-19 pandemic. Methods: Four patients participated in the study with the following diagnoses: Parkinson’s disease, stroke, peripheral facial paralysis, and tibial plateau fracture. Patients underwent up to 10 physiotherapy sessions via digital tools. The 5-A self-management tool (Assess, Advise, Agree, Assist, Arrange) guided the sessions. Results: The teleconsultation type varied between synchronous (n = 1; 25%); asynchronous (n = 2; 50%) and synchronous/asynchronous (n = 1; 25%). There was 75% (n = 3) adherence and one withdrawal (25%). As the benefits of teleconsultations, the patients pointed out the convenience, maintenance of the exercises, and contact with the professional. The reported limitations were the lack of the use of physiotherapeutic devices. Conclusion: Teleconsultations contribute to the continuity of physiotherapy treatment during social isolation. Adherence to treatment was facilitated by access to the technology and by offering patients the choice of teleconsultation type.

A Telerehabilitation Approach to Chronic Facial Paralysis in the COVID-19 Pandemic Scenario: What Role for Electromyography Assessment?

“…Furthermore, the need for telerehabilitative adaptations to exercises can challenge patients’ motivations, but, for the physiotherapist on the other hand, he can provide immediate feedback to the therapeutic plan in teleconsultation, as, among other things, it is an opportunity to see the patient immersed in his own [ 51 ] domestic context, making it possible to analyze emotional and environmental factors that can mitigate barriers and identify facilitating components [ 52 ].…”

Feasibility, Safety, and Effectiveness of Telerehabilitation in Mild-to-Moderate Parkinson's Disease

“…The remote administration of physiotherapy in PD patients is rather challenging, and the feasibility of treatment is hampered by the fear of adverse events (AEs), particularly falls without the possibility of prompt intervention by the operator. Despite these concerns, there is growing evidence in favor of the efficacy of telerehabilitation to sustain physical activity, mobility, and emotional wellbeing (23,29,(33)(34)(35)(36)(37)(38)(39). Most reports dated before the COVID-19 pandemics were focused on cognitive training, speech therapy, and dance therapy in small cohorts of patients affected by different neurological disorders.…”