How Island physiotherapists are operating in the COVID-19 era

For Island physiotherapists, the pandemic era means finding new ways to interact with patients and being deployed in hospital as part of the pandemic response.

President of the P.E.I. Physiotherapy Association Mark MacKenzie says physiotherapy clinics have adapted to providing virtual care when appropriate.

"Some of the clinics do remain available for in-person visits, but for urgent care only, with increased infection control precautions," said MacKenzie.

Clinics across the Island are using a variety of software programs to deliver telehealth services, he said, while some of the larger nationwide providers like CBI, which have locations in Charlottetown, Summerside and Montague, already offered telehealth services. 

"Patients would call the preferred clinic that they'd like to be working with and someone from that clinic would sort of walk you through what their process is," said MacKenzie.

"There'll be many, many, many things that a virtual appointment would be sufficient for, providing the professional advice. 

"In terms of mobilizing joints and hands-on techniques that physiotherapists are accustomed to using, there's just obviously no way to deliver that through virtual care."

Although there's disadvantages that come from the inability to provide hands-on treatments, tele-rehabilitation services can still be a fit for many patients, including for prescribing and progressing an exercise program, some of which can also be done with the support of another person in the household. 

Just a screen and internet

The Physio Center, a Summerside-based clinic, is offering telehealth appointments as of Tuesday.

They don't have to put their recovery on pause or live with pain.— Blythe Martin, The Physio Center

Co-owner Blythe Martin said the clinic is now offering both physiotherapy and chiropractic appointments using video services.

"As a physiotherapist I would say that the single most important component of a care plan that I would prescribe for a patient would be exercise prescription, so that isn't going to change at all from your traditional in-person visit."

"We're encouraging all patients to at least do that little trial session, free of charge, just to see if they think it's something that would work for them."

Martin said all patients require for telehealth services at their clinic is a smartphone, tablet or computer and an internet connection. 

While The Physio Center normally offers physiotherapy, chiropractic and massage services, Martin said massage can obviously not be offered virtually. 

The clinic, like many across the Island, has been closed for three weeks.

"Most insurance providers have come up with policies in the last week or two, since these pandemic circumstances started, where they will cover insurance for patients to do online physiotherapy and chiropractic appointments," she said.

"We're hoping that most of our current patients on our caseload will be interested. It will just really help ensure that they don't have to put their recovery on pause or live with pain."

Martin said the circumstances of the pandemic has forced their clinic to grow and expand, and depending on the uptake and accessibility, they may continue to offer the service in the future.

Engaged in COVID-19 response

Health PEI said that physiotherapists have also been deployed within the hospital to assist with the COVID-19 preparation efforts.

"Rehabilitation specialists including both public and private physiotherapists have been engaged to be available as part of our COVID-19 response," officials said in an email to CBC News. 

"Physiotherapists can help in a variety of roles depending on the patient's condition."

We want to help move people through the system.-  Mark MacKenzie, P.E.I. Physiotherapy Association

Officials said this applies to both COVID and non-COVID patients across the system and in medical units, including the ICU.

"Physiotherapists and other members of the physical medicine team are really patient flow catalysts," MacKenzie said. "We want to help move people through the system so that we don't have anybody using our limited equipment and limited hospital space any longer than they have to."

Although much of the research is still new on COVID-19, MacKenzie said with other types of critical illnesses, getting patients mobilized and starting rehabilitation can sometimes help reduce the number of days that someone requires intubation, as well as the total length of stay in the ICU.

He said the tasks a physiotherapist can do may help alleviate the pressure on physicians and nurses.

"One thing that we know about COVID-19 is there's a serious respiratory component to that. And one of the ways to optimize oxygenation of the patients is to have them in the prone position of lying on their stomachs."

P.E.I. has not had any hospitalizations due to COVID-19.

COVID-19: What you need to know

What are the symptoms of COVID-19?

Common symptoms include:

• Fever.
• Cough.
• Tiredness.

But more serious symptoms can develop, including difficulty breathing and pneumonia, which can lead to death.

Health Canada has built a self-assessment tool.

What should I do if I feel sick?

Isolate yourself and call 811. Do not visit an emergency room or urgent care centre to get tested. A health professional at 811 will give you advice and instructions.

How can I protect myself?

• Wash your hands frequently and thoroughly.
• Avoid touching your eyes, nose and mouth.
• Clean regularly touched surfaces regularly.
• Practise physical distancing.

More detailed information on the outbreak is available on the federal government's website.

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