Physical Therapy Isn’t Just for the Office

In-home visits by PTs grow in Rochester area

By Deborah Jeanne Sergeant

Getting to a physical therapy appointment challenges some patients more than others. Whether it’s transportation, physical frailty, social anxiety, deconditioning or scheduling, patients now can call on a number of mobile physical therapy practices serving the greater Rochester area.

Alexander Talev, doctor of physical therapy with Home Stretch Physical Therapy in Syracuse, said that his practice works with not only rehabilitation from injury, illness or deconditioning, but also maintenance programs and home safety assessments. Many patients choose at-home therapy because of the convenience if they lack the stamina or transportation to get to a therapy appointment.

“They don’t have to go anywhere as it’s in the comfort of their own home and is custom-tailored to their needs and goals,” Talev said. “There is often better carry over because we’re using the home environment to incorporate activities we’re doing in our therapy sessions so they can continue to do them on their own. We can often make recommendations of things they can do within the home like removing objects like throw rugs, rearranging furniture or seeing if they need railings or grab bars.”

Although homebound patients may rely on at-home therapy, patients need not have homebound status, as Home Stretch also provides therapy at place of employment or elsewhere at the patient’s request.

Many therapy offices treat multiple patients at a time in the clinic. Seeing patients outside a clinic also enables therapists to provide one-onone attention.

Keith Waldron, a doctor of physical therapy with Oswego Health Home Care, views at-home PT as a good bridge between hospital care and out patient PT for patients with total knee or hip replacement.

“It’s ideal so they can learn to get up and use stairs,” he said. “We get to see patients where they live. If they come to an office, you don’t see their home and their home dynamics. Even for a small window of time, that’s helpful.”

He believes that home PT is underused by those who need it the most, an issue his organization has been trying to address.

“Those are the folks that would really benefit from services in the home to build them up again and restore some of their access to community resources like social and form a wellness perspective,” he said.

It’s also helpful that patients— many of whom are in ill health—do not have to wait in a waiting room, potentially exposing them to communicable illnesses.

One drawback to physical therapy at home is the limited amount of equipment available, since it must be small, light and portable—not things such as aerobic equipment. The other option relies upon the creativity of therapists to adapt the use of objects from the patient’s home, such as using their own chair for practicing standing and sitting. But in the latter case, patients can improve function for their activities of daily living within their typical environment, which can be helpful.

At-home PT provides little stimulation for people who cannot easily get out.

“We have folks who are already challenged with being socially isolated and not going out to a clinic and being around other patients dealing with the same elements is not as helpful,” Waldron said. “There is more isolation in home care.”

New York is a direct access state, meaning patients may have 10 visits or up to 30 days of seeing a physical therapist without a referral from a physician. This provision helps patients receive care right away without another doctor’s visit and a needless copay.