ABSTRACT
Background Therapy interventions were disrupted by the first lockdown during the COVID-19 pandemic in Switzerland. An instant change to telerehabilitation had to be implemented by physiotherapists. Aim Exploration of experiences of individuals living with a long-term neurological condition receiving telerehabilitation physiotherapy interventions during the first lockdown. Method Persons with a long-term neurological condition were recruited from the outpatient clinic of a local hospital in the German-speaking part of Switzerland during February and March 2021. Semi-structured individual interviews with a phenomenological perspective were audio-recorded, transcribed verbatim and analyzed using reflexive thematic analysis. Results 4 persons, 2 with multiple sclerosis and 2 with stroke (aged 44-75), were interviewed. There were 3 main themes, of which 2 had 3 subthemes: 1) Living with a neurological condition during a pandemic (daily life without and within a pandemic, symptoms, feelings and attitudes influenced by the pandemic);2) Therapy experiences (therapeutic relationship, remote therapy, therapy experiences after the first lockdown);and 3) Family and social environment. Synchronous interventions such as live video sessions or live online groups were favored when compared to telephone calls or asynchronous digital interventions. However, for participants, it was equally important to explain how the pandemic influenced them in general. Conclusion Individuals interviewed appreciated having received therapy during the lockdown, favoring synchronous interventions. However, there are still many unanswered questions about how best to support these populations, and evidence-based recommendations are needed.
ABSTRACT
BACKGROUND: The Swiss containment strategy for the COVID-19 pandemic during the first wave in spring 2020 resulted in a moratorium on non-urgent physiotherapy via regular direct patient contact. Consequently, such physiotherapy sessions declined by 84%. This study investigates the impact of this moratorium on the use of digital remote physiotherapy in Switzerland during this period and the perceptions of its use by Swiss physiotherapists (PTs). METHODS: A cross-sectional online questionnaire was distributed between June and August of 2020 via the Swiss Physiotherapy Association (physioswiss) and various associations of physiotherapy specialists (e.g., sport, pediatric) working in both inpatient and outpatient settings. The questionnaire was designed to capture the demographics of participants and the perceptions of PTs using 33 questions in the following domains: Demography; Attitudes towards digital technology; Private and professional use of digital technology; Use of digital technology during therapy; and, Support requirements. Closed and open-ended questions were included and the frequency of answers was analyzed. Non-parametric inferential statistics were used to identify differences, where appropriate. The Checklist for Reporting Results of Internet E-Surveys (CHERRIES) was adopted. RESULTS: Participants in the survey were 742 PTs (23.5% male, mean age of 43 years, mean working experience of 18 years) from the German-speaking (75.5%), French-speaking (15.1%), and Italian-speaking (9.4%) regions of Switzerland. The percentage of PTs using digital remote therapy increased from 4.9% prior to the lockdown to 44.6% during the lockdown period. The majority of PTs did not consider that digital remote therapy could complement usual physiotherapy practice and did not plan to continue with digital remote therapy after the pandemic. CONCLUSIONS: During the lockdown, Swiss PTs adopted various low-cost and easily accessible digital technologies. However, several barriers hampered further implementation of this modality. Specific education and training programs need to be provided among PTs, appropriate digital technologies should be introduced, and a correct reimbursement scheme should be developed. TRIAL REGISTRATION: COVIDPhysio Registry of World Physiotherapy, registered 15th June 2020 ( https://world.physio/covid-19-information-hub/covid-19-covidphysio-registry ).