Tele-rehabilitation (Virtual Physiotherapy) in ontario

Purpose of tele-rehab

With the current situation in our world right now,  social distancing has become the new normal and a current necessity to help with limiting the spread of illness.  Tele-Rehabilitation (TR) can provide an alternative to those who are unable to make a physical visit for in- person Physiotherapy Assessment and Treatment secondary to social distancing, convenience or mobility limitations.  

Virtual Physiotherapy appointments have become a viable option to reduce the possibility of community spread of illnesses or in the case where individuals are not able to leave their homes.

Clinical session 

Your physiotherapist will provide you with a link by email or phone for the platform used for TR. 

Your therapist will be in a private area where audio and video will not be viewed or overheard by third parties. 

The platform meets The Physio Spot’s privacy obligations for encryption and the transmission of personal health information.  The session will not be recorded. At the time of writing of this policy the platform being used is doxy.me

In order to participate in a tele-rehab session, you'll require an internet connection, a device (laptop, computer or smartphone) with a camera capable of receiving video and audio. You should ensure that you are in a private area where you feel comfortable verbalizing responses to your therapist’s question which may include:

• the location, quality and history related to your current pain
• aggravating and easing factors for your pain
• the impact of your pain or symptoms on your current activities of daily living
• previous injuries and treatment that you may have had
• current medications and past and present medical conditions that may impact the safety of the treatment interventions and exercises chosen

During your tele-rehab consultation, your physiotherapist will begin by taking a detailed history of the above questions as well as other areas that may be important to create a treatment program for you.

Your physiotherapist may also ask you to perform a series of movements to areas of pain or associated pain areas in order to diagnose your condition.

Your physiotherapist will put together the information that they’ve gathered from all components of the examination to put together a treatment plan for you.

They may arrange one or a series of follow up consultations with you in order to ensure proper understanding of your treatment program and to progress you from your initial consultation to the point where you have achieved your treatment goals. The frequency of these appointments are decided based on their experience and in collaboration with you.

Limitations of tele-rehabilitation (Virtual Physiotherapy)

During a tele-rehab consultation your therapist will be limited by being unable to perform a hands-on assessment of your tissues or joints.  Furthermore, techniques that may be performed in clinical sessions are not practical to perform during a tele-rehabilitation session include:

• pain provocation testing to determine the exact painful structure
• passive movement assessment
• manual and manipulative therapy
• passive stretching
• hands on cueing of posture for retraining your form with exercises
• acupuncture/dry needling

Risks with tele-rehabilitation (Virtual Physiotherapy)

At The Physio Spot we take your personal health information seriously by choosing platforms that adhere to our privacy obligations and by training our staff and privacy controls.  However, when third party platforms are being used, there is always the chance that a breach could occur.  

By not recording the session through the platforms we are attempting to minimize this risk. 

Furthermore, the platform will not require you to create an account.  You will be asked to provide your name so that your therapist can see that you are waiting for your session.

Your therapist will be in a location and taking steps to ensure that the professional conversation is not overheard.  You should ensure that you are in a location where the conversation cannot be overheard.  Furthermore, ensure that you are not logged in to a public internet connection where details could be intercepted by third parties.

If you have a slow internet connection, then your therapist may lose connection.  We ask that you keep a phone nearby so that if you lose connection, your therapist can continue with as much of the assessment as possible.

During some of your sessions, your therapist may ask you to move around in order to progress your exercises or to determine how your symptoms are progressing. It is important to ensure that you have sufficient space to move around and that there are no obstacles or hazards around (such as wet floors or sharp objects on the ground). 

If you feel that you have poor balance or are experiencing dizziness or if you have pre-existing conditions that are making you concerned about how you will physically respond you should ensure that there is someone at your location that can assist you.

Benefits of tele-rehab

By performing a virtual physiotherapy examination, your therapist can create a treatment program for you that helps you to better understand and manage your pain.  This can help you to improve your function and overall level of activity.

Alternatives to tele-rehab

Some patients will choose to not have a consultation for their symptoms.  There is always the option of independently managing your symptoms.

The services of The Physio Spot are not covered by OHIP.  

Tele-rehabilitation is covered by some private insurers but not all.  You should check with your private insurer in advance to see if you have coverage for TR.  Other OHIP covered services include consultations with your family doctor, nurse practitioner or visits to your local Emergency Department

Tele-rehab  is one option for treatment. Some physiotherapy companies are available to come to your home to provide physiotherapy services.  The cost for these sessions usually reflects the travel expenses associated with the therapist travelling to and from your clinic.