Virtual PT Helps Patients Recover

By Deborah Jeanne Sergeant

As with many aspects of life during the COVID-19 pandemic, physical therapy shifted to a virtual model. However, some physical therapy offices are keeping virtual PT as an option for patients.

For Robert Berkley, doctor of physical therapy and owner of Robert Berkley Physical Therapy in Oswego, advantages include the safe, familiar environment of virtual physical therapy.

“The patient feels comfortable in their home,” Berkley said. “They can know they can do their home exercise program because they’re already at home. It’s easy to instruct the patient and not as time consuming as when they come into the office.”

Traveling to and from therapy may be physically difficult for patients already in pain and experiencing deconditioning and limited movement. It’s also tough for patients who lack transportation or whose health makes them unable to drive.

“For a more complex diagnosis, we’d need to see the patient in person, but once they’ve seen a provider with a diagnosis of back pain or weakness, we can treat them virtual- ly,” Berkley said.

Among the drawbacks is the lack of equipment, although creative therapists can usually find ways patients can perform movements with items they have around their homes.

“Sometimes, it’s difficult to instruct patients,” Berkley said. “You can’t put your hands on them to touch and feel.”

Despite this, he believes that virtual physical therapy would be more widely used if more people knew about it.

“Many people aren’t aware it’s available,” he said. “The platform is simple and easy to use.”

Virtual physical therapy can help more people enter and complete physical therapy.

“It’s all about access, like for people without transportation, who have socioeconomic restraints or who live in rural areas,” said Bryan Guzski, doctor of physical therapy and strength and conditioning specialist with Motive Physical Therapy in Brighton, a Rochester suburb. “Virtual services allow us to overcome a lot of those barriers.”

Patients do not need to be in person to discuss their health his- diseases are preventable with regular office visits and routine screening,” he said.

4.See a physician

All men should have a yearly wellness visit to screen for potential health problems. Bloodwork to check cholesterol levels and screen for diabetes is important.

“In smokers, it may be beneficial to screen for lung cancer and aneurysms, which is something we only do in men that have smoked,” he said. “We will discuss screening for prostate cancer which we may or may not do based on the individual.”

Rogall sees a combination of reasons why men hesitate booking regular visits. Some deal with the ego of manhood where seeing a physician is shown as a sign of weakness.

“Men are still much less likely to talk about their health and much more likely to downplay their symptoms,” he said. “They prioritize work and essentially anything else over self-care. Unless we have a cold, then you’re not going to hear about it.”

5.Early detection

Early detection is one of the greatest tools we have to prevent severe illness and death. By screening regularly, physicians can decrease the extent and severity of heart disease, high blood pressure, diabetes and cancers.

“In many cases, we may detect some of these early enough to reverse the course or prevent them from happening in the first place. It’s easier to blow out a candle than it is to put out a house fire,” Rogall said.

Health experts from the U.S. Preventive Services Task Force have made recommendations, based on scientific evidence about various ailments. Talk to your doctor about prostate health, obesity, high cholesterol, high blood pressure, colorectal cancer, diabetes, depression, sexually transmitted diseases and other screenings.

tory and offer an opportunity for a provider to observe their movement. As they squat, lunge, raise their arms and perform other movements — depending on their case — the provider “can get a pretty good picture as to how that person moves and functions,” Guzski said. “There’s an expectation that you need to be right by their side, but a lot of that coaching can be done with visual and verbal feedback from the provider and patient. There’s a lot of value and ways we can help patients.”

Virtual visits also permit providers the chance to see patients’ home environment. They can see how patients move and function in the place where they spend more time than anywhere else. Providers can also observe any obstacles to their ac- tivities of daily living, such as a chair that’s hard for them to use and offer suggestions that can help.

“There’s definitely no substitute for getting your hands on the patient, feeling the tissue and joint,” Guzski said. “You can have the patient palpitate, but the feedback is different. The detail and accuracy are different from a trained provider.”

He does see many advantages such as reducing the burden on primary care providers, especially urgent care and emergency rooms, since insured patients can seek physical therapy without a referral in New York and receive treatment for 30 days without a prescription. Most insurance covers virtual physical therapy just as it would in-person physical therapy.

Know the Signs of Heat Exhaustion

We’ve already had some sizzling days, and there will be many more this summer. Not everyone responds to the heat in the same way, and for some people, a stretch of high temperatures can be deadly.

Heat-related illness, known as hyperthermia, results from exposure to extreme heat, with the body unable to properly cool. Prompt treatment with fluids and cooling the core body temperature are critical to reducing illness and preventing death.

“The elderly are prone to heat exhaustion since, as we age, our bodies don’t regulate heat as well as they did when we were younger,” says physician Lorna Fitzpatrick, vice president for medical affairs and senior medical director at Excellus BlueCross BlueShield. “Often, seniors aren’t aware of the impact of high temperatures on their bodies until it’s too late,”

In addition to the elderly, the Centers for Disease Control and Prevention says people at greatest risk for heat-related illness include those who are overweight or have existing medical conditions, such as diabetes and heart disease.

Among the symptoms of heat exhaustion are headache, nausea, dizziness, weakness, irritability, thirst, heavy sweating (or no sweating), elevated body temperature, muscle cramping, and decreased urine output. If untreated, heat exhaustion may progress to heat stroke, a life-threatening condition that can damage the brain or other vital organs and, in severe cases, cause multiple organ system failure. Fitzpatrick offers the following tips to prevent heat-related illness: exhaustion includes immediate medical attention from an urgent care center or hospital emergency room. If medical care isn’t available, call 911 and stay with the individual until help arrives. Remove unnecessary clothing, including shoes and socks. Encourage frequent sips of cool water, and apply cold compresses to the head, neck, and face.

• Check on those at risk. During a heat wave, frequently check on people at risk, such as the elderly, disabled, or homebound. Check on them at least twice a day.

• Ask your health care provider if you or someone you care for is vulnerable to excessive heat. Some conditions or medications can impair the body’s ability to regulate temperature, inhibit perspiration, or restrict how much fluid can be consumed.

• Wear light clothing. On extremely hot days, dress in lightweight, light-colored, and loose-fitting clothes.

• Drink liquids. In hot weather, make sure you, or the person you care for, consume an appropriate amount of nonalcoholic fluids. Stay away from beverages high in sugar or caffeine, as they cause the body to lose more fluid.

• Don’t wait until you feel thirsty to have a beverage. By the time you recognize the thirst, you are already in need of fluids.

• Take a cool shower or bath. Taking a shower or bath with room-temperature water will allow your body to cool.

First aid for someone with heat

When did you last see your doctor? It might be time. Routine preventive care is key to staying healthy. Most screenings and immunizations are no cost when you visit a participating plan provider.* Common preventive services include:

• Annual routine checkup

• Well-woman visit

• Well-child visit

• Immunizations

• Mammography screening

Submitted by Excellus BlueCross BlueShield Learn

By Anne Palumbo