We have managed almost three weeks of face to face appointments, it’s been an interesting time but our efforts are being really well received.

Since the beginning of the lockdown we have been successfully treating clients remotely via FaceTime and Whats App. Drawing on years of knowledge and experience as well as current research, have enabled us to use treatment modalities other than hands on. As expected, there were teething problems with remote consultations, one of which being the obvious issue that the camera can not be in two places at once. It made it challenging to see a patient reaction whilst observing the movement. Another anticipated problem due to the hands-on nature of our profession is that it made it impossible to gauge how a joint felt through its range; how strong a muscle was; or what the level of neurological deficit could be, such as altered sensation or reflexes. To support a successful outcome of the remote session we follow every session with personalised short videos containing advice and exercises individual to the patients needs. In addition to this, we also recommending specific apps which could also aid the patients recovery by encouraging a structured and supportive return to full function.

In accordance with the advice given by the Government and Public Health England (PHE), we are able to ‘offer face to face appointments for those patients whose needs, treatment or follow up can not be met by safety-netting or virtual consultation’ which we have carried out successfully now for almost 3 weeks. These patients still receive an initial virtual appointment during which a full, as possible, assessment is carried out. If appropriate we discuss Covid19 health screening and obtain shared consent for treatment and an appointment is made. Once at the clinic, each patient is met from their vehicle, they are encouraged to wash their hands and advised to wear a face mask whilst on the premises. The Physio will wear full PPE as recommended by PHE for face to face contact and adhere to the 2m social distancing rule as much as is possible with the exception of ‘hands on’ treatment. Once the treatment session is over the room is cleaned, disinfected and allowed an air change of at least 20 minutes before another patient can use the room, again in line with current advice.

There is much conversation about how tiring zoom meetings are. Users have to concentrate harder to interpret the other persons feelings due to limited visible body language however, in this situation, they are imperative. Carrying out the initial virtual appointment is invaluable. Not only does it improve the control of the spread of Covid19, due to minimising the risk to both parties during treatment, it also allows a relationship to form between the Physio and patient whilst facial expressions can be seen. Without this, both parties would meet for the first time with their faces partially obscured by masks and this measure helps to make the whole experience during this time feel less daunting. This has been recognised as a problem widely in the hospital setting where patients are scared, unwell and not moving. Here we have patients in pain and about to trust a stranger to make them move and possibly to reproduce their pain, whilst partially undressed. They have numerous questions they would like answering and possible treatment scenario’s to be explored before informed consent for treatment can be reached. Apprehension is even more challenging to assess without facial expressions but trust is definitely improved by giving patients time during the initial virtual assessment session and we feel that the post treatment video clips whilst being a great instruction tool also allow the patient to get a feel for their
physio’s personality.

We can help by treating a number of conditions including but not limited to MSK. We can see a need arising to be more involved with post Covid19 patients not only with chest care and mobility, but with continence issues post cough and goal setting, support and return to normal activities due to mental health issues. Where this is not best placed to take place in clinic, domiciliary visits can be arranged.

If you wish to, please pass on our details. Visit https://wvphysio.co.uk or follow us on Facebook or Instagram. There are a number of excellent reviews. We still see patients within 24 hours of receiving a referral and have great flexibility with appointment times.