Physiotherapists take virtual 'hands-on' approach to treatment during COVID-19 pandemic

Physiotherapist Paul Colebrook guiding a patient through a virtual treatment at Pro Physio on Riverside Court. Ottawa, ON. April 16, 2020. (Tyler Fleming / CTV News Ottawa)

OTTAWA — Physiotherapy is an essential service but, during the COVID-19 pandemic, hands-on therapy is only available for the most critical of cases, forcing many practices to shutter their doors. That has patients who rely on those treatments left in knots.

Now, one business wants to alleviate those symptoms with virtual care.

At Pro-Physio Sports Centre on Rivergate Way, the lights are dimmed, the more than 15 treatment tables are empty, and everything is clean and organized, waiting to reopen.

Paul Colebrook, clinic director and physiotherapist, is at his station, working with his patient, NCAA alpine skier Helen Hume. They're doing exercises and stretching out an ACL injury Hume acquired from a fall during a race in January. She will need surgery, but it needs to heal as best it can first.

However, she’s not allowed to be in the clinic.

Hume's injury, as bad as it is, isn’t critical. Instead, she’s there virtually. A laptop is on Colebrook’s treatment table. He is standing in front of the camera in a video conference, as he demonstrates and explains the exercises Hume needs to do.

“It’s very important she gains full range of motion before her surgery,” says Colebrook, who has been working with Hume weekly. “We can't abandon someone who's under our care and we're still able to see them and help them.”

COVID-19 has forced many of the Pro Physio clinics to close. It is medical care and is an essential service, but only critical patients are allowed face-to-face treatment. Even then, the guidelines from the College of Physiotherapists in Ontario are stringent.

“I would say were operating at about 10 to 15 percent of our previous capacity,” Colebrook says, “but at this point in time is not so much about saving our businesses it's making sure that we're delivering care to those clients that need it and really helping out a lot of clients that do need to care.”

A virtual appointment is virtually the same as a physical appointment. It starts with a consultation and some questions about overall health. Then, it moves on to the physical aspect, where the patient is given instruction on how to stretch, watching demonstrations by the physiotherapist and following along.

Not everyone has the tools and exercise equipment at home that the care center would normally provide, so Colebrook says he has to get creative.

“Physios are a very inventive bunch,” he says. “A lot of times we're going to use the stuff around the house: we’re taping soup cans together for weights, they’re using pillows as wobble boards, so we're doing all different ways to provide and deliver care.”

The Pro Physio centres, with more than 30 locations around the region, had a virtual platform in place before the pandemic struck, but it was not used as much as it is now. Colebrook says he was sceptical at first whether the care would be similar but, after dialing in with patients over the last two weeks, both he and his clients are happy with the service and they agree it has been a positive experience.

Before the pandemic, Colebrook would see more than 15 patients in a day. Currently he is seeing about half that number, but word is getting out and the numbers keep growing.

If your physiotherapy is insured, Colebrook says that most companies are covering the treatments, but you should check first.

Hume is thankful for the virtual appointments and says that the sessions have been beneficial in her recovery. She’s hoping to be back on her skis by January.

“The recovery necessarily hasn't been easy and I haven't even got surgery yet but I've seen a lot of improvements from January till now in terms of mobility and strength.”

For Colebrook, virtual care has opened a window into how well people do their exercises, and he sees the benefit of supervising that and watching their progress.

“It's been an eye-opener for me because a lot of times we prescribed exercises for people to do at home but it's very interesting when you actually see them do them.”