Carlos Cano, A leading Physiotherapist in Telerehabilitation
Today we talked to Carlos Cano to find out more about his views on the latest evidence in musculoskeletal recovery, specifically the hand-wrist-fingers segment, the importance of the sensorimotor approach, and the potential of new technologies such as ReHand.
Who is Carlos Cano?
Carlos is a Physiotherapist graduated from the University of Malaga and is currently responsible for the AMS Exercise Medical Centre in Málaga, Spain. He holds a Master’s Degree in New Trends in Health Sciences Research and also holds a PhD with a thesis entitled “Instrumented Manual Physiotherapy and Aquatic Functional Recovery”, Cum Laude.
In addition, he is currently developing his teaching profile within the area of sports rehabilitation, and has a very extensive research background. Carlos Cano’s profile is really impressive, and one of the reasons why we decided to ask him some questions about the current state of hand therapy.
Many studies have reported how musculoskeletal pathology has a direct impact on the somatosensory cortex. How important do you think it is to approach the post-surgical patient from a sensorimotor level?
Very important. If we understand the patient from a biopsychosocial point of view, a surgical process acts as a “traumatic” event on many levels of the patient, both on a psychosocial level (stress due to the uncertainty of whether the surgery will go well, whether they will recover quickly to return to their work or sporting activity with guarantees, etc.), and on a biological level (suture healing, biological repair of the structures affected and surgically treated, subsequent immobilisation period, etc.). All these factors, alone and together, will affect the sensorimotor control of the different affected structures and will have to be addressed if recovery is to be optimal.
In which cases have you been able to use ReHand?
At the AMS Exercise Medical Centre we have been using this technology since March of this year. Since its implementation, I have been able to use it in various pathologies such as reflex sympathetic dystrophy (Sudeck syndrome), carpal tunnel syndrome surgery, fractures of different fingers and metacarpals, arthroplasty for thumb Osteoarthritis, and epicondylopathies.
Here you can see one of the patients Carlos has treated at AMS. Specifically, a post-surgery rehabilitation at the level of the third metacarpal:
The latest evidence advocates the use of adherence promotion strategies when prescribing exercise programmes. How do you think the ability to monitor your patients remotely has impacted this?
Adherence to treatment and, above all, to the prescribed therapeutic exercise is essential for optimal recovery. Since we have ReHand at our disposal, we can monitor our patients’ adherence to exercise, knowing how much time they dedicate to their daily exercise programme and therefore, how much importance they themselves give to their own recovery. This helps us to give them feedback that they appreciate (often the feedback is to congratulate them on the correct performance of the exercises, other times to indicate if they need help in any of them -the app gives us information if there is an exercise that is not being performed correctly or is more difficult- or in some cases, to indicate that they should do more exercises if they want to recover correctly (“scold them”)).
Does telerehabilitation contribute to the physiotherapist-patient relationship?
Yes, it helps this relationship to be stronger, when we have feedback about their recovery outside the consultation room. Although we must not forget that the doctor-patient relationship is forged in person, in person, and with the passing of days and sessions; at least this is my opinion.
What do patients think?
Patients are delighted, as they have a personalised tool to do exercises that help them in their recovery process. In addition, it does not require a large financial outlay as in many cases they do not need to buy any exercise equipment and the Tablet that they, their children or grandchildren usually have is enough. Moreover, they can perform the exercises at home as many times as they want. They see how the exercises become more and more difficult (progression) and this motivates them even more and they get feedback from me.
Carlos already wrote about ReHand in his blog entry, read it by clicking here!
Would you recommend using the ReHand tool?
Of course, any physiotherapy centre that has a regular influx of patients with finger, hand, wrist and elbow pathologies will benefit from the implementation of ReHand, at the Exercise Medical Centre we are very satisfied with the implementation, because it increases the effectiveness of physiotherapy sessions, and gives us an added value that the patient usually appreciates.
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