Digital health is already a reality in the health sector. In recent years we have witnessed an important evolution in the world of physiotherapy and rehabilitation, incorporating new technologies and treatments.
In this post, we interviewed Montse Nuevo Gayoso, a physiotherapist at the Hospital Clínic Barcelona, to tell us about his experience on the use of new digital tools applied to the area of health rehabilitation.
Tell us about your career
I have a history of 25 years and for 9 years I have dedicated my working day to the Rapid Recovery Fast Track project of prosthetic knee surgery, although I have treated all kinds of patients with pathology, especially the musculoskeletal system. Member of “Treball de l’Actualització 2019 Grup de la Prescipció d’Exercici Physics per La Salut” as well as the “GPC Treball Group on Osteoporosi I prevented fracture per Fragilitat” (2013) and the “Grup d´Experts per to define the characteristics of the malalties rehabilitation process of the Nerviós System” (2006).
I am also secretary of the “Scientific Society of Physioteràpia” in the “Acádemia Ciències Mèdiques i de la Salut de Catalunya i de Balears” and I was president of it for the years 2008-2016. In addition, I was president of the “Technic Committee of Physioteràpia of the Consell Català de Formació Continuada de Les Professions Sanitàries” and “Avaluator” from 2010 to 2018.
What do you think of new technologies and what benefits does it bring to rehabilitation?
Currently, thanks to technology, we have acquired new ways of communicating, relating, etc. Anything that may be digital is already being or will be. There is no doubt that the health sector could not be left behind, much less when we are talking about an improvement, without a doubt, for people’s health.
The greatest beneficiary of the digital age in the health system is the patient. Currently I am sure that mHealth helps the patient with an active participation in his health process, that is, we empower him, we give him a more active role.
In addition to achieving this empowerment, the professional can, remotely, know that his patient is carrying out the treatment, interconnect with him to motivate him and increase adherence to therapy, in addition to knowing that he is performing the entire process correctly, otherwise, to be able to intervene before he could be late This technology allows you to connect with the patient and help them rectify and follow a correct treatment.
Personally and as a physical therapist, I believe that the digital rehabilitation platforms add up and, everything that is to add for a patient treatment, is positive.
What advantages do you think the monitoring sensors offer to rehabilitation?
Important, it is a great advantage because it gives greater precision and greater control. Being able to control the patient through a sensor to know if he is performing the exercises, how he performs the movement, at what times of the day he performs them, knowing if he is following a good pattern, with his corresponding pauses, knowing his heart rate, the steps he takes, the length of them… and many others Aspects that can be achieved, safely, with this type of technology, makes functional recovery much more precise and controlled, allowing the treatment for each patient to be correct.
As a physical therapist, is it essential to follow the entire rehabilitation process?
Without a doubt, and this is often difficult. Telemedicine in this case can be a great solution, since, at present, both in hospitals, CAP’s, mutuals, etc., it is difficult to have the patient from the moment he needs a physiotherapy treatment, due to the waiting lists that occur, and also get to be with the patient until the entire functional recovery process is completed.
Thanks to new technologies, we can manage to care for our patients, knowing at all times if they are carrying out a pattern of exercises and how, participating in improving adherence to treatment, motivating them to do it by coaching and trying to make them understand the importance of not decaying throughout the rehabilitation process.
All this in a short space of time. Everyone knows that the time that can be spent with each patient in the public system or in the different mutuals is scarce due to the pressure of care. Telemedicine allows you to have all the data of the exercises carried out by the patient and make the corrections in a short space of time. This improves treatment, helps increase your adherence or simply reinforces you because you are doing everything correctly, making you feel that you are not alone and that you have someone on the other side of the connection from the beginning of the treatment to your full recovery.
Is communication between professional and patient important in rehabilitation therapy?
From the outset, every health professional who has to treat the same patient should speak the “same language” with some common references. In this way, the person feels treated closely.
The way of communicating with the patient is implicit in the way people are and empathy is basic, thinking about how you feel at that moment to adapt to your situation to the maximum.
Active listening is very important, the patient needs to feel listened.
In Physiotherapy, what are the keys necessary to make it complete and effective?
Undoubtedly, physiotherapy has many benefits and provides positive aspects for the health of patients in different aspects:
- In prevention, improving posture, re-educating different postural behaviors and to avoid injuries to the spine.
- In pain, physiotherapy can help improve and eliminate the symptoms of some pathologies, relieving pain and inflammation in musculoskeletal lesions.
- In the management of degenerative diseases, the musculoskeletal, neurological, respiratory and cardiovascular system, etc., with a preventive and therapeutic approach addressing the physical condition of the patient as well as the management of the consequences of the disease itself.
- In the reinforcement of the structures of the musculoskeletal system, improving joint mobility and flexibility, with the consequent prevention of injuries and recovery in case of injuries already established.
itself, One of the main objectives of physiotherapy is to increase the well-being and quality of life of people.
Sometimes, the treatment involves needing the hands of the physiotherapist and manual therapy, and on other occasions go through, once the patient’s assessment is made, that the physical therapist prescribes a pattern of exercises so that they can carry them out autonomously. It is in these cases where a digital rehabilitation platform such as REHUB shows its effectiveness.
Could you share your experience using Rehub?
REHUB It is an ideal platform for patients who have musculoskeletal problems, to prevent the progress of the pathology and to prevent future complications, without forgetting the usefulness of rehub for anyone who wants to perform therapeutic exercises controlled by a professional physiotherapist. This will organize a progressive exercise pattern adapted to their needs to achieve maximum effectiveness without injuries, which is what often happens to people who go to the gym closest to their home to do a series of exercises that, in most cases, are not suitable for them.
Nowadays There is great scientific evidence that underlines the importance of therapeutic exercise in people’s health.
If we focus on a person with a certain pathology, Rehub is a great tool for professionals.. The professional can check at any time the evolution of the patient or client, if he performs the exercises, if he does them correctly and thus motivates him both to improve their practice and to congratulate him on the progress.
REHUB It allows you to carefully observe different aspects of carrying out the exercises, but also allows you to observe the work of the patient at a glance.
It undoubtedly improves communication between professionals and the patient, because through the chat, both can be connected at any time.
Why is it necessary to design a custom rehabilitation?
Kick! Each person is a world, and each patient must be prescribed an individualized pattern based on an analytical assessment and adapted to the moment. In addition to the pathology to be treated, it is necessary to attend to the injuries or collateral effects that they have and work on the prevention of injuries.. We must always adapt the therapeutic exercises to the needs of the patient.
Even when we work with clinical practice guidelines endorsed in pathologies that have a predictive response, for example, in patients with knee prostheses, we must keep in mind the person in front of us, and adapt the guide to each situation and each need, attending to the needs of each patient.
Why is adherence important to the treatment of patients?
Adherence to treatment is influenced by the patient’s state of motivation, his situation -not pleasant because he is going through a difficult moment of health-, the understanding of the instructions given, the incompatibility between the activities of daily life (AVD) and his state, his personal history, the Acceptance he makes of the effort to which he has to submit, the coping with his own pain that he is experiencing in his postoperative period, including his beliefs, if his recovery work is really necessary once the prosthesis is implanted,… All this makes many times difficult for patients to follow the guidelines they should be to obtain a good functioning of your prosthesis.
Through all the experience that I have accumulated both in patients in the postoperative phase and at home, I can assure that adherence to physiotherapy treatment is sometimes a complicated challenge.
Finding fully adherent patients with sufficient willpower to autonomously perform physiotherapy exercises is difficult, they are a minority.
When the patient is in the immediate postoperative period, for example, those who have undergone surgery on the knee prosthesis, with their pain, their edema, their inflammation, their bruising, etc., it seems that they find enough excuse to leave some of the sessions scheduled during the day (sometimes all) and we know the importance of performing the entire physiotherapy regimen at this precise moment to help improve all the symptoms I have talked about.
Also when several days go by and they are better, they find the perfect excuse to deceive themselves again and decide that, since they are better, why carry out the entire pattern, even reaching the event that some patients, if they are active, decide to return to work.
Both moments are crucial for the good evolution of the process they have gone through; Once the surgical intervention has been carried out, the most important thing is the functional recovery process, a good muscle reinforcement, achieving all the range of movement that the new joint can offer, making a good gait pattern, adapting the knee to the activities of daily life, etc.
Undoubtedly, the adherence of patients is important, and in this case, especially Rehub is of great help.
Without good adherence, the patient loses and the economic and social cost increases, since possibly, this arthroplasty, if the patient does not collaborate what is necessary, could suppose possible complications in the future.
Would you recommend the use of digital platforms for rehabilitation?
Of course, it can be a good tool added to the specific treatment by the physical therapist. We must never forget the need, on many occasions, of manual therapy by the physiotherapist. But in addition, a programmed guideline like the one carried out by Rehub could allow, in a physiotherapy center, for example, the physiotherapist to be carrying out good manual therapy, while his other patients are carrying out an individualized exercise regimen, with the certainty that they are performing correctly.
How do you think physiotherapy will be in the future?
I hope and wish that With the new technologies we can all make the assessments much more objective in terms of joint balance, muscle, even evaluating parameters that are not possible manually, such as the speed and quality of each of the exercises.
It is also important to be able to supervise patients until the end of their functional recovery and be able to prescribe different exercises to carry out from the beginning of their treatment until their total recovery. And beyond, get the patient to understand the importance of movement, the importance of exercise and have people and not just patients, who ask to carry out a pattern of healthy exercises without possible injuries due to malpractice.