Physical Therapy Telerehabilitation on COVID-19 Patients - A Literature Review

Introduction: The impact of Covid-19 has revolutionized how Physical Therapists provide treatment to patients to reduce the risk of infection, since most rehabilitation is done in close proximity, social distancing has been the main challenge when providing treatment. For physical therapy rehabilitation, it is imperative to provide treatment that still focuses on the recovery of function, strength, and movement of the patient. It is necessary to explore what are the best ways of implementation to maximize the patients' benefit. The purpose of this literature review is to analyze studies that focused on physical therapy through telehealth and the overall outcome of these visits. Methods: This review utilized randomized control trials and systematic reviews of various populations and settings using the following search terms: Telemedicine, Telehealth, Telerehabilitation, Covid-19, Physical therapy. All articles are dated within the past 2 years from PubMed, Scopus, and Google scholar. This literature review examines the effectiveness of telehealth in the era of Covid-19. Results: The population analyzed in these studies varied from infants to older adults. Results varied on each study, but all concluded with advantages and disadvantages of Physical Therapy Telerehabilitation. The main advantages were reducing travel fatigue, the general strain on the body, and minimizing travel cost. Some of the disadvantages found were the adaptability of both patient and therapist to limited treatment options, technological barriers, and reduction in equipment accessibility. Out of all the therapy sessions provided, 85% were telerehabilitation sessions, of which 94% out of those had to follow ups and patients expressed being at least satisfied with the service. Women participated more frequently and reported a higher level of satisfaction than male participants. A consensus was made and reported that 92% of the patients that participated in the telerehabilitation sessions were willing to continue with this practice. Overall physical therapy increases clinical effectiveness, functionality, quality of life, and user satisfaction. For patients recovering from COVID-19, telerehabilitation improves their vital respiratory capacity, increases respiratory muscle efficiency, and decreases fatigability levels. Conclusions: Physical Therapists recognize the value in training for virtual treatment delivery and continue to provide specialized rehabilitation services with new technical and clinical skills. Telehealth systems are the solution for the shortage of hospital beds and their home-based style can provide clinical benefits, cost-effectiveness, and simplicity. The implementation of telehealth services has been feasible and acceptable with the support of policy in favor of the expansion of telehealth physical therapy. The telehealth models now available globally are proving that telerehab is not inferior to standard rehabilitation. Clinical Relevance: Telemedicine services provide essential care for patients without increasing the risk of Covid-19 spread. Although it has some challenges, it is most accessible throughout all health care practices and has the potential to shape the future of the patient provider relationship, especially for physical therapy.