Physical Therapy & Home
Would you want a physical therapist in the home?
Telerehabilitation has been around for over 20 years but really grabbed my attention in 2018 at Combined Sections, our PT national conference. Kristin Archer, Rana Hinman, and Helen Hoenig presented a talk “ACE Talk: eHealth Technology for Rehabilitation and Mobile Health Applications.” They spoke about how they are transforming rehab and broadening services into the home in innovative ways. Much of the work Dr. Hoenig presented from the Department of Veterans Affairs proved equal if not superior outcomes for telerehabilitation. My eyes were opened.
Then came the pandemic and the use of telemedicine skyrocketed. It was the only way some people could get healthcare the past 2 years. But does it work? Do people feel they are getting the same level of care? The evidence points to yes.
Several years ago, a study surprised me with the outcomes achieved in the home. The LEAPS trial was a groundbreaking trial that compared standard home-based physical therapy to harnessed-treadmill training in persons with stroke. They found no difference between groups, which at the time, was SHOCKING. My jaw was literally on the ground when I heard the results. I thought this was finally going to be the study that showed how great treadmill training was for people with a neurologic illness. WRONG. People who exercised at home, under the direction of a highly skilled neurologic PT, did just as well with walking at the end of the study. Being around your own place, in your own kitchen and bathroom, and using equipment you own —this worked! Strength training with your dog by your side? This worked! People got better without having to leave their house.
Was this home-based study the same as tele-rehab or video PT? Not exactly, but I think the key ingredients are the same— support from a skilled PT, therapy focused on the person, and goal setting that is specific and individualized. I know I would want PT this way. I want to schedule when it works for me, I want to save money and time on parking, and I will remember how to do the exercises if I have performed them at home before. Would I want a PT to come to me? YES.
Ashley Stanley PT, DPT