Making Rehab A Virtual Reality

When COVID-19 shut down much of the world this past spring, Franciscan Health’s team of rehabilitation therapists were determined to safely provide their patients' care, despite a pandemic.

Today, Franciscan Health’s team of rehabilitation therapists are offering speech, physical therapy and occupational therapy sessions, from the comfort of a patient’s home, through virtual rehabilitation.

“What we’re really looking at is that’s the future of how we’re going to build care. It’s not to replace physical contact, it’s to complement it,” said Randall Moore, MD, senior vice president and COO of Health and Care Solutions at Franciscan Alliance. “It’s to be able to bring people together from different geographies without needing to be in the room at the same time, for families to be connected, for us to tap into outside expertise, as well as to bring all our internal expertise to bear on a case.”

What Is Virtual Rehabilitation?

Virtual rehabilitation visits allow patients to connect with speech, occupational or physical therapists through their computer for at-home sessions. At Franciscan Health, virtual visits begin with patients logging into their MyChart account to access video, while providers use the hospital's electronic medical record software, Epic. Both systems are encrypted and secure to ensure privacy.

Physical therapist Dusti Chase says although virtual visits aren't appropriate for every patient and their needs, virtual rehabilitation offers benefits for many on their road to better health.

"Virtual visits may not look the same, but a therapist can guide, observe and check mechanics," Chase said. "Research shows the outcome for virtual rehabilitation is the same as in-person for certain conditions."

Sydney and her mom are sold on the virtual option.

"Using virtual therapy is easy and convenient," said Amy. "You still connect, have a relationship with the provider and receive great services. I can't imagine where we'd be if we had lost those four months. Sydney didn't miss a beat, still progressed and learned how to manage her condition."

Susan Burton of Greenwood had seen physical therapist Cambrea Schlarb, DPT, a Franciscan Health Indianapolis therapy pain specialist, for chronic pain related to a herniated disc and arthritis. Therapy and participating in a pain recovery group helped reduce the pain and taught Susan how to manage symptoms.

When her pain flared again right before the pandemic hit, Susan returned to physical therapy. Once virtual therapy visits became available, Susan decided to give it a try.

"Therapy helps me manage symptoms and helps me function with more energy," she said.

Virtual visits would also help manage her pain another way — eliminating the drive to an appointment.

"Driving is painful for me and always increases my fatigue and weakness," she says.

During the 40-minute sessions, they worked through strengthening and range-of-motion exercises. Schlarb showed Susan an exercise, then watched her do it. She could make modifications and address issues right away.

Schlarb also included pictures and instructions of the exercises in MyChart, and new ones so Susan could continue to progress. "It was like an in-person visit because she provided the same guidance and resources," says Susan.

Susan said a visual connection made the difference.

"Having someone I knew cared about me who was going to see me on-screen, encouraged me to keep going," she says. "It's such a good option.”

Children And Virtual Rehab Visits

7-year-old Caiden Bettley had been attending regular speech, physical and occupational therapy sessions at Franciscan Health Fitness Centers in Schererville for spastic diplegia, a mild form of cerebral palsy.

But during the early stages of the pandemic, those in-person sessions were put on hold. After about a month, the Bettleys decided to try physical and occupational therapy through Franciscan Health’s telehealth services.

Physical therapist Mary Lu Kot was able to guide Caiden through exercises to help her continue her progress by using items around their house. Kot uses a rag doll to portray movements so patients can follow along. Caiden loved the rag doll so much, she offered it as incentive to encourage progress on one of her goals.

“It was amazing the progress she made because she was so motivated,” Kot said. “We’re trying to make it a fun time, so they get the therapy they need.”

‘Virtual Therapy Is Easy And Convenient’

Thirteen-year-old Sydney Neubert of West Lafayette was getting ready to start speech therapy for vocal cord dysfunction (VCD) with Jessica Tucker, a speech language pathologist at Franciscan Health Lafayette when the pandemic hit. VCD causes the vocal cords to close, making it hard to breathe. Therapy teaches breathing techniques to relax the vocal cords and make breathing easier when the condition flares up.

Instead of video calls, Tucker went old-school and used the telephone to coach Sydney and her mom through videos of breathing exercises they watched while on the phone together.

After three weeks of phone calls, Tucker began therapy with Sydney via video, coaching her through breathing exercises and educating her about the differences between asthma and VCD and how to manage them.