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March 31, 2020
By Carolyn Yates, PT, DPT
During this pandemic, many of us have been advised, or ordered, to stay at home. While this will hopefully “flatten the curve” and reduce the spread of the coronavirus, it also means that many of the ways we take care of ourselves may no longer be an option. However virtual options are growing and can be a great and safe alternative to in-person treatments. Telehealth physical therapy, or virtual physical therapy, can be a great option for anyone who was already being seen by a physical therapist or was about to make their first appointment.
Telehealth is the use of electronic communication to remotely provide health care information and services. Telehealth physical therapy can include physical therapy services offered via phone, live video, recorded video, and other electronic communication methods.
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Telehealth has been gaining popularity as an alternative to in-person treatment, especially for those seeking cost-effective options and those in rural areas without access to local practitioners. Now, it’s gaining even more ground as a way to get treatment and still follow social distancing recommendations.
The biggest difference between telehealth PT and in-person PT is that you will not receive any hands-on or manual treatments. However, you will receive advice and instruction in exercises to do as well as various ways to perform some of the hands-on treatments yourself.
The “exam” part of the session will still happen. However, it will all be based on your movements. With regards specifically to pelvic floor PT telehealth, you will not have an internal exam. Without an internal exam it is difficult for the physical therapist to know how strong your pelvic floor muscles are and whether you are performing pelvic floor muscle contractions (aka Kegels) correctly. This is not an issue at first because the pelvic floor physical therapist can use verbal cues and education to help you learn how to perform the exercises correctly. If, after a couple of weeks of being treated through telehealth, your symptoms are not improving, that would be an indicator that you would need to consider going in to see a pelvic floor physical therapist in person.
Telehealth does afford you more flexibility for scheduling since you do not have to travel anywhere for the session. Many physical therapists offer sessions outside of their regular office hours, since they can be done anywhere.
This completely depends on what you are getting treatment for and where you are at in your rehabilitation journey. In general, less equipment is needed for pelvic floor PT. However, having some bands and light weights at home would be helpful as you progress. You will need a smartphone/computer/tablet in order to engage in the telehealth appointment. Having a form of video conferencing is ideal so that the therapist can see what you are doing and you can see what the therapist is doing as she/he demonstrates exercises.
In general, telehealth is covered by commercial insurance companies. However, the coverage varies state-by-state and is also dependent on your individual insurance plan. Typically, Medicare does not cover telehealth for physical therapy. However, with the COVID-19 pandemic, rules and regulations are changing quickly to ensure that everyone can continue receiving treatment through this time when we are required to stay at home. At the time of publication of this article, regulations for Medicare have been loosened but there are still many rules to follow. If you are in need of pelvic floor PT and have Medicare insurance coverage, reach out to your local pelvic floor PT to find out how they can help you during this time.
Telehealth physical therapy can be very effective. Although it does pose challenges to treatment, physical therapists can still do all of the patient intake questions, education, exercise instruction, implementation of plans of care, and prescription of home exercises all via telehealth. The manual, hands-on aspect of physical therapy is not available but remember, most of your rehabilitation relies on what you do outside of the physical therapist’s office. This includes your home exercise program and avoidance of activities that exacerbate your symptoms.
Carolyn Yates, PT, DPT is a Colorado State licensed Physical Therapist with a pelvic floor rehabilitation specialty. She received a Doctorate of Physical Therapy (DPT) from Belmont University School of Physical Therapy and is the owner and head physical therapist of Verity Physical Therapy & Wellness in Boulder, CO.
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