Virtual Physiotherapy Consultations 
When we were hit with lock-down at the end of March we were immediately forced to think of how we could help our patients moving forwards and keep them ‘going’ under Covid 19. We got our Pilates classes on to zoom straight away and are still running 9 classes a week with 150 people participating including from Spain, France and Italy! We offered Video consultations to our current patients and about 40% initially took us up on that and were very surprised at how well they went. 
Since the start of Covid 19 the virtual appointments have been utilized by a very large number of our patients, and we will continue with them on a permanent basis for some patients once we are fully operational again. Many of the Pilates clients have also asked if we will continue with virtual classes once we are back in the studio. All our Physiotherapy appointments had to be virtual as we were unable to carry out any face to face consultations until July. 
We are now many months into Covid 19, and while we await a return to what was our previous routine as soon as is safely possible, some of the changes that we have been forced to make in the clinic are starting to feel a bit more normal, or ‘The New Normal’. We now know that many of these changes will actually be here to stay. 
Our guidelines state that the first physiotherapy appointment for any patient needs to be virtual. We have continued with this guidance to keep both our patients and staff as safe as possible. The initial assessment is 45 minutes and we want to keep our patient to therapist face to face contact down to half an hour where we can. We can get as much done in a virtual consultation as we would in a face to face one. 
Some patients are reluctant to have virtual assessments as they feel that they need hands on treatment. However, our initial assessments are so in depth that even if they were face to face there is little time for much hands on treatment anyway. We spend this first session listening to them, assessing them, giving them a diagnosis and planning their treatment and exercise programme. If the patient needs hands on treatment, then we can get them in for face to face appointments for their follow ups as long as medically it is safe to do so. 
What is virtual physiotherapy? 
Many people are very sceptical about a virtual physiotherapy appointment thinking that we cannot treat them without hands on treatment. Even we were a little dubious to start with but boy were we wrong! When many people think of physiotherapy they think of hands on treatment, but while this is an important part of our work, it is only one single element. However, we do appreciate that nothing can totally replace a face to face consultation, but the virtual ones have been extremely effective. We are very experienced physiotherapists who spend time listening to our patients and virtual appointments actually heighten our senses for listening and observing. Virtual physiotherapy offers a different way to get support from a physiotherapist without the need for face-to-face visits, through a video consultation, or phone call and exercises patients can complete in the comfort of their own home. 
There are many advantages of virtual physiotherapy including:- 
No restrictions: 
Virtual physiotherapy is as good as face to face for providing individual advice and education to help patients manage their own symptoms. We can also provide patients with individually tailored exercise therapy and rehabilitation, self-joint mobilisation, self-trigger point release and other soft-tissue treatments including taping techniques! We can also advise on what is the best exercise equipment and where to source it. 
You can connect with a physiotherapist, regardless of your UK location: 
We have had patients contact us for virtual appointments via recommendation nationwide which we would not be able to do if we only had face to face appointments. Should these patients then need face to face treatment then we can put them in touch with their nearest Physiotherapist. 
Private and secure: 
All virtual physiotherapy and pilates sessions are provided through a secure, encrypted connection. The physiotherapist will be the only person present throughout the appointment. Patients will be sent a consent form which includes advice about making sure that they have privacy at their end. 
Patients are so pleased to be able to get treatment from the comfort of their own home. It saves them a lot of time as they only need to set aside 30-45 minutes for the appointment itself rather than adding in time for travel and there is no need to arrange childcare, transport and they can book less time off work. Now that many people are working from home this makes it easier for them to integrate their appointments in to their working day as they only need 30-45 minutes. 
More holistic approach to treatment: 
While patients attending an appointment in the clinic often expect hands-on treatment, virtual physiotherapy enables a more holistic approach to treatment. The format encourages more conversation and provides our Physiotherapists with a better opportunity to ask questions and provide advice, education and reassurance, while also tackling some of the psycho-social aspects of pain. Our Physiotherapists have really excelled in this area, which is why our virtual appointments have been so successful. 
Patient engagement: 
Getting patients ‘on board’ has been much easier with the virtual appointments than we anticipated as they seem to be more engaged and motivated. We go through all the exercises with them at the time of the appointment and check that they are doing them correctly. We then follow up their appointment with a bespoke copy of their exercises done through Rehab My Patient which is emailed to them. This is a PDF format but each exercise is accompanied by a short video clip as a reminder for them. 
Insight into home situation: 
Having a virtual appointment enables us to see the patient’s home environment. We have been able to see what home exercise equipment they have and can advise as to what they may need to get and where they can access such equipment. 
We have had access to their home work station set-up, which has been indispensable for those patients who have contacted us with neck, back and shoulder issues since working from home. This would not be possible with face to face consultations and we have been able to give on the spot advice and talked them through adjusting their set-ups until we can see that they are right.. 
What conditions can be treated with virtual physiotherapy? 
Almost all of the illnesses and injuries that we would normally see in clinic can be treated with virtual physiotherapy. These include: 
• Back pain 
• Joint pain 
• Muscle pain 
• Sports injuries 
• Vertigo 
• Women’s and Men’s Health issues 
Moving forwards: 
As was said previously, our virtual physiotherapy and pilates sessions have been so successful that we will continue with them into the future. There are many of our pilates clients who had previously had to stop coming into the studio for pilates due to work commitments. They have rejoined us for the virtual classes and are very keen to continue with virtual classes beyond Covid-19. 
We also have patients who are quite happy to continue with virtual physiotherapy sessions as they are working well and it is much more convenient for them. 
Here is looking forward to the New Normal and embracing the changes that it has brought. 
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