Let's face it. 2020 has been a year of uncharted territory across all reaches of the globe. The outbreak of COVID-19 earlier this year caused a global pandemic that has left the human race scrambling for answers and assistance, all while trying to “stay safe” in their homes and in the workplace. This rapidly spreading pandemic has wreaked havoc on schools, businesses, entertainment, restaurants, the health care industry, and more. Nearly all aspects of health care have been affected by this pandemic, which has claimed the lives of more than one million individuals.
Rehabilitation therapists have been severely affected by this global crisis. Since physical and occupational therapy is traditionally a very “hands-on” specialty, how to handle continued patient care has been especially challenging. Therapists around the world are still providing face-to-face therapy services while ramping up infection control processes and wearing masks and/or face shields. Outpatient clinics, skilled nursing facilities, and even acute care facilities have experienced reduced patient loads due to the significant reduction in elective surgical procedures as well as the widespread community efforts to follow “stay-at-home” orders. Despite the reduced demand for face-to-face rehabilitation, physical therapists and other rehabilitation professions are still uniquely positioned to help patients who are at risk for functional decline during social distancing and times of quarantine. Not only do social distancing and quarantine efforts limit an individual's access to rehabilitation services, but they can also limit a person's opportunity for physical activity. Rehabilitation therapists are uniquely trained and poised to provide education for patients in physical activity and exercise. Since the demand for “in-person” or “face-to-face” therapy sessions has drastically reduced over the past 8 months, the emergence of “telehealth” or “telerehabilitation” has taken center stage for many therapists who are still trying to provide therapy services in a safe, yet effective, manner. Telerehabilitation is the supplying of health care remotely by means of digital telecommunications technology.
Prior to the outbreak of COVID-19, telerehabilitation was minimally used by rehabilitation therapists to provide therapy services, in part, due to lack of reimbursement for the service. However, the pandemic has ushered in a booming of the telerehabilitation platform, which is enabling therapists to remotely evaluate and treat patients while eliminating risk of COVID-19 exposure. Using telerehabilitation, therapists can provide patients with evaluations, followed by implementation of a treatment plan that emphasizes education and patient follow-through. In this issue, we would like to highlight an article, titled “Telerehabilitation for Older Adults,” which thoughtfully discusses the many different aspects of rehabilitation that can be done using digital telecommunications technology.
Also in this Thieves' Market issue, we are presenting a case study report from Spain that highlights the use of physiotherapy intervention in the recovery of a 38-year old woman who recovered from acute respiratory failure secondary to SARS-CoV-2 infection. In addition, we are pleased to provide a wide array of other topics that will provide more evidence for your practice. Have you ever pondered the answers to these questions? Is handgrip strength test result an indicator of osteosarcopenic obesity? Do virtual reality applications help in the treatment of balance and gait speed for individuals with Alzheimer dementia? Can the relationship between cognitive decline and physical function be analyzed using a Classification and Regression Tree (CART)? What are the effects of laser photobiomodulation therapy on muscle performance and perceived exertion? What is the relationship between performance in the Timed Up and Go test and foot clearances during obstacle crossing in older women? What is the impact of executive functions on the performance of activities of daily living in Parkinson disease? Is the occiput-wall distance an important marker in physical function and mental health of nursing home-dwelling older adults with severe flexed posture? Can blowing into a party horn help improve respiratory function and swallowing in the older adult? Do progressive plaster casts decrease knee flexion contractures? Is there a relationship between balance status as scored with the Berg Balance Scale and the Hendrich II Fall Risk Model and risk of falling? As you can see, we have a tremendous variety of evidence-based research for you to read in this issue.
We here at Topics in Geriatric Rehabilitation do not know how this COVID-19 pandemic has affected you. We hope this issue will provide some useful and practical evidence to implement in your practice. The issues caused by this global pandemic have, no doubt, affected each and every one of us both at home and at work. Our hearts are with you all as you perform your jobs of promoting health, wellness, and prevention for your valuable older patients. It is our hope that this issue will give you excellent information and useful evidence as we all navigate this uncharted territory. Be well and stay safe.
—Wendy Powers James, PT
Topics in Geriatric Rehabilitation