The COVID-19 pandemic has greatly changed how we do things in the United States. From the way we shop and eat to the way we interact with others around us, many of us are concerned about risk of exposure to the virus as we undergo errands outside of the home. As more areas begin to re-open following stay at home orders, many are critically appraising their comfort with returning to activities and businesses that they frequented prior to the pandemic.
Lately, patients are often curious if it is safe to return to physical therapy given its high contact nature or if they should wait and delay care until a later date. For many, this is a very personal decision and depends on several variables, including the nature of the injury/condition, their medical history, and their comfort with leaving the home to go to a medical office.
Should Physical Therapy Treatment Be Postponed?
In general, waiting for care is not ideal, as the orthopedic and neurologic problems most often seen in the physical therapy setting tend to become more challenging to treat as time goes on (i.e. as the condition becomes chronic). Certainly, a patient should start physical therapy if they have recently undergone a surgical procedure and have been referred to PT by their surgeon for post-operative care. In this case, delaying treatment could lead to poor recovery after surgery and long-term problems afterwards. This will become more common as surgeons resume elective surgical procedures.
Most other cases are less cut and dry. A patient who recently strained his back while doing yardwork would almost certainly benefit from in-person physical therapy sessions but his comfort and appropriateness for in-person sessions depends on other factors. A 22-year-old man with no other health problems may feel comfortable wearing a mask and coming to in person sessions, following normal social distancing protocols as best as possible. Telehealth options may also be a considered depending on the complexity of his case. Conversely, an 85-year-old man who has COPD and is currently undergoing chemotherapy likely would not be comfortable wearing a mask and would prefer to utilize a telehealth option to deliver care in the safety and comfort of his home given his compromised immune system. Ultimately, there are options available and therapists are flexible to work around these challenges; the priority is to provide effective care while minimizing the risk to the patient.
Safety Precautions in Access Physical Therapy Locations
COVID-19 is a challenging bug to manage from an organizational standpoint; you can see in news articles how hospitals and nursing homes struggle with minimizing spread in their facilities. The virus is easy to transmit from person to person if precautions are not followed and it can be difficult to identify in asymptomatic individuals. Outpatient physical therapy clinics face similar challenges to inpatient facilities, although there are some important differences. In all cases, ensuring proper cleaning and hygiene protocols is critical to reduce the risk of spread between individuals. Use of protective equipment such as gloves further reduces this risk, especially when caregivers and patients both utilize protection. However, since physical therapy clinics are not equipped to treat COVID-19 patients, we screen our patients before coming to therapy to ensure that they do not have any symptoms associated with the virus in order to try and limit its entrance into the clinic in the first place.
In short, we try to keep the virus out of the building as best we can. We then assume it is in the building anyhow and try to do the best job we can cleaning to reduce the risk of spreading it between people, just in case. Is this excessive? Maybe, but we think we are all worth it!
To this end, social distancing and self-isolation techniques are still important and physical therapists should continue to maintain distancing as much as possible with their patients and other staff. This may involve adjusting treatment techniques, but it can also include treating in private rooms and minimizing patient congregation in the waiting area or gym. Patients can seek facilities that offer one-on-one treatment to reduce contact with other patients and providers as well.
Ultimately, attending physical therapy in the wake of COVID-19 can be beneficial in treating acute and chronic issues alike, although the exact method of delivery will likely depend on a person’s medical history and comfort level. Certainly, discussing the needs and concerns with a physical therapist can be helpful in determining the options available and finding the ideal path to take, so consider calling an Access location for guidance on your specific situation.
The health, safety and well-being of our patients and staff remain our top priority here at Access Physical Therapy & Wellness. To reduce risk of exposure to COVID-19, we are following all social distancing precautions, limiting the number of people in the waiting room, cleaning all equipment with medical grade disinfectant that kills COVID-19, and closely monitoring CDC guidelines and adjusting protocols as new information becomes available.
Eric Fontaine, PT, DPT
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