Telehealth physical therapy during the COVID-19 pandemic: an experience description

Abstract Introduction The actions and measures taken to mitigate the coronavirus pandemic significantly affected physio-therapy practice. Several initiatives were undertaken after the Federal Council of Physiotherapy and Occupational Therapy approved remote care. Thus, we aimed to identify, analyze, and discuss barriers, facilitators, and perceived challenges of telehealth physical therapy during the pandemic by describing an experience. Report description: The interruption of weekly face-to-face consultations led to remote care strategies using asynchronous methods, in the form of phone calls (health education), and a synchronous approach via video calls formats (mind-body practices without a pre-established frequency in the public service and twice weekly in the private sector). The type of personal device determined the health care delivery. The facilitators were interpersonal relationships, patient profile, type of personal device and previous experience with mind-body practices. The barriers were low education level, access to internet and type of connection. Challenges were restriction or absence of therapeutic touch and eye gaze, which are characteristic of the profession. Conclusion Despite its significant potential for the continuity and longitudinality of health care and development of social networks, telehealth depends on technological resources and, as such, tends to be exclusive due to the inequities in Brazil. Additionally, telehealth has relevant repercussions for physical therapy practice, especially therapeutic touch and eye gaze, which are soft skills inherent to the profession.

摘要与引言：为缓解新冠疫情所采取的各项防控举措，对物理治疗（physio-therapy）执业活动造成了显著冲击。在巴西物理治疗与职业治疗联邦委员会批准远程照护方案后，诸多相关实践举措得以推行。本研究旨在通过梳理自身实践经验，识别、分析并探讨疫情期间远程医疗（telehealth）物理治疗所面临的障碍、促进因素及感知挑战。

报告详述：每周面对面诊疗服务的中断，促使团队转而采用非同步式远程照护策略：以电话沟通开展健康宣教，同时通过视频通话提供同步式干预服务。其中，公共卫生服务体系内的该类干预无固定频次要求，而私立机构中则为每周两次。服务的交付方式取决于患者个人使用的设备类型。促进远程照护顺利开展的因素包括医患人际关系、患者群体特征、个人设备适配性，以及既往参与身心练习的经验。而阻碍远程照护推广的因素则为患者受教育水平偏低、互联网接入条件不足及连接类型受限。本次实践面临的核心挑战在于，物理治疗行业标志性的治疗性接触与眼神交流受到限制甚至完全无法开展。

结论：尽管远程医疗在维持医疗服务连续性与纵向连贯性、拓展社交支持网络方面具备显著潜力，但它高度依赖技术资源，受限于巴西国内的资源分配不均问题，往往仅能覆盖部分人群。此外，远程医疗对物理治疗执业活动存在显著影响，尤其是治疗性接触与眼神交流这两项职业固有核心软技能的应用受到极大限制。