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Hybrid telerehabilitation in pelvic floor muscle therapy

The term “hybrid therapy” has been used in recent times quite often in connection with COVD-19. The notion in question is about a combination of in-person appointments with monitoring the patient’s health and the progress made in the process of rehabilitation between these appointments. It’s not yet another fancy term but a solution recommended for a long time. One that has recently proven to be really useful in the healthcare industry.

The golden standard of treatment?

In some fields of medicine, e.g. in the case of cardiac patients, telerehabilitation is already a standard. Numerous studies prove that cardiac telerehabilitation is an essential stage of proper therapy, and deciding not to make use of it is considered medical malpractice. That’s why it has been included in the practice guidelines of the European Society of Cardiology. It’s a very effective method of monitoring the effects of rehabilitation. It also helps patients self-discipline themselves as it creates a sense of obligation. It gives noticeable and measurable effects/biofeedback, which motivates the patient to stick to a given activity and work with the therapist. After all, it’s all about the patient’s health in the end.

Telerehabilitation reduces social costs. Not all patients have the possibility to attend regular appointments in a treatment room. It’s often a logistical challenge for them because of problems with commuting or other family obligations. Telerehabilitation is very convenient because the patient is able to adjust their daily agenda in a way that lets them spare even a moment to exercise, the effects of which will pay off with time.

An essential solution for today

It’s also important to consider the fact that the number of e.g. positive cancer cases has substantially decreased lately. Does it mean that patients are healthier? Unfortunately not. It means that they’re afraid to seek medical advice or that their check-ups have been postponed by a few weeks or months. And that their untreated condition gets even worse. This happens also to a smaller or larger degree also in other fields of medicine, including pelvic floor muscle therapy. If patients with pelvic floor muscle dysfunctions delay getting examined and starting the right treatment, it may turn out that it’s too late for them to start conservative treatment.

Many practices have reopened and schedules are full but we need to remember that the pandemic is still real. If we have an option to arrange part of the therapy as online sessions, we should take advantage of it. Plus, we don’t know if we’re not going to see additional restrictions being put in place regarding on-premises consultations, which may make it difficult or even impossible to get medical advice.

The stages of hybrid rehabilitation

Modern and comprehensive hybrid telerehabilitation involves making interventions during regular treatment room visits and following a rehabilitation program at home. It consists of two stages:

1. Initial stage

  • Gynecological diagnostics – qualifying patients for conservative treatment of pelvic floor dysfunction
  • An appointment with a pelvic floor muscle physiotherapist:
    – examination, assessment of the motor pattern, elimination of compensation,
    – muscle test and providing the patient with an intravaginal probe
    – designing an individual plan of pelvic floor muscle training with the use of telecare.

2. Basic at-home stage
The patient exercises at home using the device and the app, following the individual plan designed by the therapist. Follows the schedule of check-up visits.

Is telecare for your patients?

The first element to start telerehabilitation is qualifying your patients for the exercise program. It’s probably common for you to suggest pelvic floor muscle training to your patients. If you wish to plan and supervise the therapy in detail, you can suggest exercising with PelviFly. When specialists make this qualification, they are asked a couple of recurring questions by their patients.

“Why exercise with a device when you can exercise without one?”

It’s possible to exercise pelvic floor muscles without the device, of course, but it’s much harder and doesn’t make it possible to monitor the occurring changes well enough. If a woman who starts her training is asked to exercise at home and activate her muscles at 20% of her capacity, it’s very likely she’ll be doing it incorrectly, using too much force. This means that even if she exercises regularly, she won’t be following the recommendations she’s received.

It can be prevented if the patient exercises with biofeedback and sees how her muscles work on the phone, and the specialist has access to all her results on the telecare platform. PelviFly algorithms adjust the training load to the patient’s current muscle strength determined during cyclical muscle tests performed with the use of the device and the app. This way the patient knows how to exercise the right way.

Let’s be honest – pelvic floor muscle exercises are quite monotonous, so it’s very hard to make regular exercising a habit. The training becomes much more motivating if you exercise playing a game on the phone and collecting points for your achievements. What helps is also the awareness that there’s a specialist on the other side, monitoring your progress and ready to give you tips and remind you of the tasks you might have skipped.

“At last, pelvic floor muscle exercises are a true pleasure, not a ‘chore’. And the best thing – I see what I do wrong and I can correct it. For instance, I don’t always relax fully (but it’s getting better), and I’ve become aware of it thanks to the feedback I get from the app. Finally, I’ve learned how to use my muscles so as not to make the device fall out (at first, I was more of a pusher). I got the hang of it thanks to the planned training.” – a review by a patient under the supervision of Zosia Budkiewicz, physiotherapist

“I need to think if it’s really for me”

It’s natural you need to give it some thought before you decide to start the training. Pelvifly.com offers a lot of information, but the best thing to do is to experience how PelviFly works firsthand.

Patients can test the device in treatment rooms run by our Partner. The muscle test performed with the PelviFly device and app is a great tool to check both the control the strength, and the endurance of muscles or the patient’s ability to relax after contraction. It makes it also possible to learn how to activate and relax muscles correctly.

Many specialists who work with us let patients borrow the device. It’s really enough to disinfect it properly and use a barrier sheath – like the one used with the head of the endovaginal ultrasound transducer. If a patient wishes to test the device and exercise for, say, 3 months, it is by all means possible.

“It’s too expensive”

If you have the device, you can always choose if you want to exercise free-of-charge or go for one of the higher-tier – and paid – options. The best idea for patients-beginners is to exercise under the supervision of their physiotherapist – this way, the patient will get the right support at the most difficult stage of training. To exercise supervised, the patient can make individual settlements with her physiotherapist of choice and take advantage of all the features of the highest-tier option called CARE.

How to implement hybrid telerehabilitation in your practice?

Online course

To start using PelviFly, it’s enough to take part in an online training, which we’ll make you ready to use PelviFly both in the treatment room and when monitoring your patients’ training remotely.

Free tests for all patients

After the course, you can start using PelviFly in your practice, starting from muscle tests performed in your treatment room. It’s enough to have just one device and disinfect it properly and use a barrier sheath – like the one used with the head of the endovaginal ultrasound transducer.

Immediately after each test/training is finished, you get access to relevant reports in the app. The PelviFly app is free of charge – there are no costs involved in performing the tests in the treatment room.

PelviFly muscle test – assessment of one of the 6 test stages.
1. a screenshot with the course of the test;
2. a report available right after the test.

Telecare in your treatment room

To get access to advanced data available on the telecare platform (charts, detailed parameters) and be able to design and manage training plans for one’s patients, it is necessary to sign a partnership agreement. After choosing the preferred partnership model and signing the agreement, you can start running rehabilitation programs for your patients who exercise at home in your practice.

PelviFly telecare platform – a chart and parameters describing a training session of a patient exercising at home

Every partnership model lets you make settlements for telecare with your patients, without the agency of PelviFly. The patient is then required only to send us her consent for making her data available to us, and we give her access to the Care option (the highest-tier option in the app) and assign her app account to your account on the telecare platform.

There are plans at different prices available, depending on the partnership model you have chosen. The fee for the basic plan – COACH – is EUR 15 per month.  You can easily estimate the profit you’ll make on telecare services. If you have 5 patients per month, each paying EUR 40, your profit will be EUR 185 per month.

Some specialists are afraid that patients may start the therapy at home and then stop coming to the treatment room. Actually, it’s quite the opposite – the patients who exercise with PelviFly tend to schedule appointments more regularly. This is so because we educate them and increase their health awareness, and specialists remain in touch with them and suggest making appointments on a regular basis. When you supervise your patients remotely, you can not only extend the scope of therapy but also make it more regular.

We hope that every woman in every country can be reimbursed for the cost of telerehabilitation in pelvic floor physiotherapy really soon. But there’s no point in delaying its implementation in treatment rooms. Join us on our next online training.