The 6 challenges for rehabilitation and clinical practice in 2021

2021 has come . It has been such a difficult year and everything indicates that this year will bring us even more important challenges. And today we want to share with you the most interesting insights and tools that we have identified in order to face them.

1. Safety

For the patient and their families, but also for us, healthcare professionals. The current model by which we treat several patients in the same room has been called in question and today, it is hard to be kept by following the restrictive and mandatory safety measures.

Protection and security measures against COVID-19 are essential.
Telerehabilitation is a very powerful tool in that sense.

Telerehabilitation can definitely help to be safer. And we are not the only ones who thinks so. According to the article recently published by the University of Toronto (2020);

“Telerehabilitation provides an opportunity to maintain the function, prevent future hospitalizations, and assist with discharge from hospitals, while maintaining physical distancing recommendations” (1).

Read more about Telerehabilitation and its importance in the treatment of the Upper Limb.

2. Economic stability

Many of us are concerned about how 2021 will evolve concerning the economy. For physiotherapists and small clinics, planning, optimizing and making profitable investments can be the key.

The application of new technologies is a challenge that many of us have already launched into and it may be more accessible than you think.

3. Acceleration of Recovery

For those of us working in the field of Physiotherapy and Rehabilitation, getting the patient back to work in the shortest possible time is essential.

Thus, and based on our recent 2020 publication in the Journal of Physiotherapy, we can affirm that patients who worked with ReHand obtained early clinical improvements, early recovery and a reduction in associated medical consultations and sessions. On average, patients treated with ReHand in this study recovered 18 days earlier (95% CI -33/-3) than the Control Group.

Healthcare professionals must be at the forefront of incorporating digital tools with ReHand into our clinical practice.

This work shows the potential effect of new technologies in the patient’s outcomes.

4. Differentiation

Patients are increasingly looking for better performance thanks to easy access to information, . They seek therapies that are adapted to them and improve their health outcomes but also ensure the highest healthcare quality in a safe environment. Today, this challenge represents a real opportunity

“An opportunity to redesign services within a new framework of innovative practices that can extend beyond the immediate crisis” (2).

In this sense, the World Health Organization (WHO) has considered digital health solutions as one of the most promising approaches to face this challenge in modern societies (3).

5. Personalization (of treatment)

It is nothing new, the treatments must be adapted to the patient and not the other way around. Patients evolve differently and better when their treatments are specific. The problem is usually the lack of time to design these plans and follow up one by one.

Treatment must be tailored to the patient, both in terms of pathology and physiology.

Treatment must be tailored to the patient, both in terms of pathology and physiology.

When we developed ReHand we took this into account: the ability to customize the treatment and its progression without being time consuming.

6. Improvement of your patients

Patient improvement is the constant challenge. Obviously it is not something unique for 2021 but we have decided to leave it until the end because it is always the most important. Of course, it is a multifactorial challenge and it depends on us as clinicians:

–Customization of the treatment.

–Progression according to the process of evolution, pathology and phase.

–Control and improvement of adherence to treatment.

–And an approach based on the latest scientific evidence.

These were the main pillars that drove ReHand and that have achieved the spectacular results obtained.

7. Sensorimotor focus of the wrist (bonus track)

And going from the general to the specific, let’s talk about a point that we find exciting for this 2021. The approach to hand wrist and finger injuries from a purely anatomical and biomechanical point of view is incomplete in terms of recovery (4.5). The importance of the sensorimotor and proprioceptive sphere of the wrist is highly remarkable (6), given its affectation in hand pathology, either by immobilization or by the pathology itself (7).

The use of touch screens, as in the case of ReHand through the screen of a Tablet, allows it to work at the level of the sensorimotor sphere (8,9), promoting an early recovery. This working tool, together with its prescription and monitoring system has been tested in previous clinical trials with more than 600 patients, having published works in high impact scientific journals such as

Post-surgical Trigger finger exercise with ReHand app on tablet touchscreen

With ReHand we are tackling these 6 (+1) challenges and thanks to this we have been able to help colleagues from different countries in the European Union. We will be happy to explain in more detail how you can do the same and apply it to your clinical practice.

References

1. Quigley, A, Johnson, H. (2020). Transforming the Provision of Physiotherapy in the Time of COVID-19: A Call to Action for Telerehabilitation. https://doi.org/10.3138/ptc-2020-0031-gee

 2. Tack, C., Grodon, J., Shorthouse, F., & Spahr, N. (2020). “Physio anywhere”: digitally-enhanced outpatient care as a legacy of coronavirus 2020. Physiotherapy, S0031-9406(20)30390-4. Advance online publication. https://doi.org/10.1016/j.physio.2020.07.004

3. World Health Organization. 2020 Mar 07. Responding to community spread of COVID-19: interim guidance, 7 March 2020.  https://apps.who.int/iris/handle/10665/331421

4. Lluch A, Salvà G, Esplugas M, Llusá M, Hagert E, Garcia-Elias M. El papel de la propiocepción y el control neuromuscular en las inestabilidades del carpo. Rev Iberoam Cirugía la Mano. 2015;43(1):70–8.

5. Esplugas M, Garcia-Elias M, Lluch A, Llusá Pérez M. Role of muscles in the stabilization of ligament-deficient wrists. J Hand Ther. 2016;29(2):166–74.

6. Hagert E. Proprioception of the Wrist Joint : A Review of Current Concepts and Possible Implications on the Rehabilitation of the Wrist. J Hand Ther. 2010;23(1):2–17.

7. Valdes K, Naughton N, Algar L. Sensorimotor interventions and assessments for the hand and wrist: A scoping review. J Hand Ther [Internet]. 2014 Oct [cited 2018 Jul 30];27(4):272–86. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25193532

8. Algar L, Valdes K. Using smartphone applications as hand therapy interventions. J Hand Ther. 2014;27(3):254–7.

9. Larsen LH, Jensen T, Christensen MS, Lundbye-Jensen J, Langberg H, Nielsen JB. Changes in corticospinal drive to spinal motoneurones following tablet-based practice of manual dexterity. Physiol Rep [Internet]. 2016 Jan ;4(2):e12684. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26811055