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Virtual Physiotherapy during COVID-19

11 May 2020 4:21 PM | Anonymous member (Administrator)

I’m doing neck mobilizations, a technique used to improve joint mobility and reduce pain. Today, I’m doing them by myself, sort of.

I lean my neck toward my left shoulder, stretch out my arms to the right and increase the tension of the towel wrapped around my neck. The opposing forces create an intense but comfortable stretch in my right neck muscles. I straighten my neck but keep the towel taut, then repeat the cycle 10 times. 

Claire Harris gives a patient acupuncture to relieve muscle tension. The adjustment to virtual physiotherapy does not allow for this type of treatment. Photo: Jacky Chow

Typically when my neck is sore, I have the experienced hands of my physiotherapist, Claire Harris, working out the knots. In a sense, I still do.

Harris explains via virtual (or video) physiotherapy, how this exercise will improve my neck range of motion and calm my nervous system. She then moves on to showing me exercises to strengthen my upper back. At the same time, I’m quizzing her.

My virtual physio sessions have been the norm since March 27, the day the Alberta provincial government announced closure of clinics to reduce the spread of COVID-19. 

“The method by which we had to provide care needed to change in a very short period,” Harris says. “There are disadvantages. We’re not able to palpate structures with our hands and we lose some of the therapeutic interaction. But there are also positives: research strongly supports emphasizing active treatment, which empowers the patient.”

Some patients may even find unexpected benefits from virtual treatment. Harris says a patient who once only requested manual therapy has had to adapt to a more exercise-based treatment.

“She has taken more ownership of her recovery with guidance from myself,” Harris says. “She’s doing very well. She’s gone from minimal physical activity to exercising every day.”

Harris says the recent adjustment of peoples’ daily routines, as well as the mental stress of COVID-19, has had a significant impact on the chronic pain population. 

“People who are now working from home may have suboptimal desk setups, or they’re working from the kitchen table, or maybe they’re spending a lot more time picking up after children, which can cause flare-ups.”

She explains stress alone acts as a mechanism that increases output of the sympathetic nervous system which is responsible for the “fight or flight” response. This makes nerve endings and areas of the brain more sensitive, causing pain, or the perception of pain, to increase.

Continuing to provide people with management strategies, especially for those in more severe pain, gives people an alternative to seeking emergency services. In a time when a visit to the emergency room not only means potential exposure to COVID-19, but undue stress on an already overworked healthcare system, these virtual treatments are especially valuable. 

“I think initially patients are skeptical about doing an online treatment, but once they do a session, most of them are quite open to it,” Harris says. 

She asks me to repeat the movements she used to assess me at the beginning of our appointment. I bring my ear toward my left shoulder with considerably more ease. It seems my range of motion has improved. 

“The intent of physiotherapy is to try and customize exercises specific to the patient. We’re not a moot point just because we can’t touch you.”

By: Kate F. Mackenzie 

Kate F. Mackenzie is a journalism student from Calgary with a degree in Kinesiology.


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