TELEHEALTH IMPLEMENTATION IN DIFFERENT NEUROLOGICAL PHYSIOTHERAPY SETTINGS WITHIN THE US DURING COVID 19 – KEY LEARNINGS IN ACADEMIA AND CLINICAL PRACTICE

N. Hajela¹, H. Garg²

Background: The novel coronavirus (COVID -19) pandemic has significantly impacted all aspects of healthcare delivery and education and has brought telehealth at the forefront of the physiotherapy (PT) profession. The risk for exposure has necessitated the academic and clinical professionals to incorporate online teaching, learning and clinical practice experiences for PT students and patients in a quick and safe manner.

Purpose: This report aimed to describe the key learnings associated with telehealth adoption and implementation in two different types of neurological rehabilitation settings (academic and clinical) within the United States (US).

Methods: Data was derived retrospectively from an academic setting in California, which transformed their sixteen doctoral PT students’ clinical education learning to a video-based telehealth model in stroke rehabilitation. Secondly, data from a community clinical setting in Utah was included to describe the feasibility, safety, initial outcomes and patient perceptions from an online group telewellness exercise model in twelve individuals with Multiple Sclerosis (MS) (mean [SD] age = 54.3 [14.05], BMI = 28.48 [5.8]). The telewellness exercise program consisted of aerobic, resistance, balance and flexibility training components recommended for people with MS. For the academic setting, the student telehealth learning perceptions and experiences were collected from self-reflections of their clinical performance after 8-weeks of clinical education and data was thematically analyzed. For the clinical setting, feasibility, safety, and training-related functional changes and participant perceptions were determined by adherence to the prescribed daily dose, number of adverse events, within-group differences and thematic analysis.

Results: Within the academic setting, doctoral students reported improved professional behaviors and increased confidence in safety, communication and clinical reasoning skills. Within the clinical setting, individuals with MS demonstrated high session adherence (80.1%), reported minimal adverse effects and demonstrated changes (p<0.05) in self-reported functional status post-training. Lastly, several themes on the perceived patient barriers, facilitators and suggested improvements of the MS telewellness program were identified.

Conclusion(s): Both, the academic and clinical settings report that telehealth is a feasible, safe and well-received alternative in student clinical education and neurological physical therapy needs. Since the PT educators and clinicians are navigating an uncharted territory during the COVID-19 pandemic, digital or telehealth practice solutions for clinical education and patient management can be critical. Future research is required to determine best ways to develop telehealth-oriented clinical professional skills and educational models in doctoral PT students, and to best practices to effectively introduce and evaluate telehealth outcomes for all stakeholders in neurological PT.

Implications: This report highlights the key learnings during telehealth adoption and implementation in two different PT professional settings (academic and clinical), therefore suggesting feasible and acceptable ways to include technology in enhancing the student and patient care experiences during COVID-19. Findings from this report will provide educators and clinicians with strategies to implement telehealth in different neurological settings.

Funding, acknowledgements: Dr. Hajela was the recipient of Provost's Faculty Scholarship Support Program, California State University, Fresno, CA, USA

Keywords: COVID -19, Telehealth physiotherapy, Stroke and Multiple Sclerosis

Topic: COVID-19

Did this work require ethics approval? No

Institution: California State University, Fresno

Committee: Research and IRB Committee

Reason: New Approach in Clinical Education