12: PTs Able To Use Tele-Rehab Flashcards
(19 cards)
Opposition Opening Statement
• Tele-rehab cannot replace hands-on care, detailed exams, or real-time interventions.
• Relies too much on virtual platforms, risking diagnosis accuracy, patient safety, and treatment outcomes.
Opposition Arguments
- No hands-on = No gold standard care
- Legal and safety risks
- Elderly may struggle with tele-rehab due to difficulties and poor network access
What supported the opposition argument “No Hands-On = No Gold Standard Care” ?
- Hands-On = Better Pain Relief
• Manual techniques (e.g., joint movement, massage) reduce pain faster than exercise alone.
• Helps patients feel better and trust therapy.
Example: Back and neck pain respond better to joint mobilization with exercise. - Hands-On = Personalized Care
• Therapists can feel issues like tightness, swelling, stiffness.
• Allows more accurate and effective treatment.
What supported the opposition argument “Legal and safety risks” ?
- Limitations in Immediate Response:
• Tele-rehab doesn’t allow physical help during emergencies (falls, dizziness, cardiac symptoms).
• Delayed intervention increases risks for patients needing urgent care. - Lack of Standardized Safety Protocols:
• Many tele-rehab programs lack formal safety measures (scoping review)
Only few studies used strategies like:
- Pre-assessing the environment
- Live warning systems
• Shows need for clear, universal safety guidelines.
What supported the opposition argument “Elderly may struggle with tele-rehab due to difficulties and poor network access” ?
- Many older adults have limited digital literacy:
• Struggle to use tele-rehab platforms or understand the process.
• Leads to confusion, missed sessions, or poor engagement. - Poor internet access affects the quality of tele-rehab:
• Unstable video/audio disrupts assessments and exercises.
• Therapists can’t clearly observe posture or movement.
Affirmative Opening Statement ( How did they define Teletehabilitation )
• Telerehabilitation is the delivery of physio services using communication tech (e.g., video, phone)
• Used when in-person visits aren’t feasible
• Also called telephysiotherapy when done by PTs remotely
Affirmative Arguments
- Continuity of Care & Home Exercise Programs
- Affordable and Accessible Care for All
- Comparable Effectiveness of Telerehabilitation
What supported the affirmative argument “Continuity of Care & Home Exercise Programs” ?
• No Gaps in Treatment: Tele-rehab ensures consistent care during illness, travel, or lockdowns.
• Real-Time Feedback: Patients don’t need to wait weeks for input.
• Digital Tools (balance trackering apps)
• Functional Training in real environments
• Personalized HEPs: PTs tailor and demo exercises live (e.g., using PhysiApp).
Which app and who’s opinion did the affirmative team use to support their argument “Continuity of Care & Home Exercise Programs” ?
• PhysiApp is a tele-rehab app used in Kuwait, offering videos, tracking, reminders, and secure communication (Adopted by Pediatric PMR in 2023; won Najmat Al Salama Award 2023)
• PT Nada reports PhysiApp improves home exercise consistency and offers tools for exercise perscription, education, tracking, updates, and easy communication.
What supported the affirmative argument “Affordable and Accessible Care for All” ?
• Cuts costs (travel, time off work, childcare).
• Reduces wait times, speeds up treatment.
• Provides convenient, timely care from home.
• Aids those with mobility or chronic conditions.
• Boosts rehab participation and overall recovery through better access.
What supported the affirmative argument “Comparable Effectiveness of Telerehabilitation” ?
• Tele-rehab shows similar outcomes to in-person care in musculoskeletal cases.
• Especially useful for post-surgical recovery (e.g., knee replacement, shoulder rehab).
• Effective for chronic diseases like arthritis, osteoporosis, and fibromyalgia.
Meta-analysis of 4,400+ patients found tele-rehab is equally or more effective in:
• Pain reduction
• Range of motion (passive flexion)
• Muscle strength (quadriceps)
• Cost-effectiveness
Opposition Rebuttal to “Continuity of Care & Home Exercise Programs”
• Without therapist supervision, patients often don’t follow the plan.
• Incorrect or skipped exercises slow progress—this isn’t true “continuity.”
• Tele-rehab may look good in theory, but not in real life.
Opposition Rebuttal to “Affordable and Accessible Care for All”
• Not truly accessible without Wi-Fi, a device, or tech skills.
• Those who need care most may be excluded.
• So, it’s not really “for all”—more like “for some.”
Opposition Rebuttal to “Comparable Effectiveness of Telerehabilitation”
• Some treatments require hands-on care (joint mobilization, muscle tension), and “no screen can replace that.”
SO claiming it’s “just as effective” is a stretch.
• Studies from several countries (South Korea, US, KSA, Phillipines) highlight the same barriers: poor internet, tech issues, high cost, and low digital skills.
THEREFORE, Telerehab seems promising BUT faces major challenges
Affirmative Rebuttal to “No hands-on = No gold standard care”
• Hands-on care is only one part of physiotherapy; many gold-standard methods (exercises, education, posture correction, pain relief) work well remotely.
• Tele-rehab is effective when manual therapy isn’t essential, and hybrid models provide hands-on treatment when needed.
• Evidence shows outcomes for many conditions (like post-op rehab or chronic pain) are comparable to in-person care.
Affirmative Rebuttal to “Legal and safety risks”
- Regulated & Approved:
Tele-rehab platforms follow national regulations and are approved by the Ministry of Health only after meeting safety standards. - Careful Patient Selection:
Only cognitively stable and ready patients are chosen to ensure safety. - Legal Risk Managed:
Legal risks exist in all settings, but following clinical protocols and documentation minimizes them.
Affirmative Rebuttal to “Elderly may struggle with tele-rehab due to difficulties and poor network access”
- Digital Literacy Rising:
75% of older adults now own smartphones. - Caregiver Support Helps:
Caregivers assist with virtual setups, often easier than clinic visits. - Hybrid Models Work:
In-person for hands-on; online for follow-ups. - User-Friendly Platforms:
Tools like PhysiApp are designed for all age groups.
Opposition closing statement
• Tele-rehab helps but can’t replace the safety and quality of in-person care
• Manual and real-time techniques are essential for best outcomes
• Physical therapy should stay hands-on
Affirmative closing statement
• Tele-rehab is a proven, safe way to support physiotherapy (e.g., Kuwait’s PMR with PhysiApp)
• It’s not a replacement but a flexible add-on for home programs and follow-ups
