Pia Delano and is a physiotherapist from Chile. She has been working for more than 5 years in pediatric oncology rehabilitation at Centro de Rehabilitacion oncologico Foundation Nuestros Hijos. Pia is also a member of SIOP Young Investigators and wanted to share with us her experience with tele-rehabilitation with her pediatric oncology patients.
It was the first week of March 2020 and the first positive COVID-19 case had been found in Chile. The pandemic was late to arrive at this corner of the world, but it only took two weeks for it to paralyze the country. Mandatory quarantine began around March 15th, and we had to figure out a way to keep on providing rehabilitation for our pediatric cancer patients for the ‘month’ that we were going to be at home. Would it work? How could we do physiotherapy interventions via webcam? Did kids nowadays even know what a webcam was?
Our first challenge was to choose the platform for this: skype was too old school and WhatsApp videos was too personal, so we decided on zoom. For the first weeks we created guidelines to send our patients, powerpoint presentations with exercises to share and we looked for ideas online. However then came a problem we hadn’t fore sought many of our patients did not had internet access in their homes. Through an endowment we were able to provide our patients with not only internet but also tablets to use for therapy. And so, our journey began.
As a physiotherapist who was taught that nothing can replace the ‘hands on’ intervention with patients, we were quite skeptical of how our sessions were going to be. We had nothing to fear! In this pandemic, our little patients and their families saw our therapy as a break from it all. Parents and siblings began participating in the exercise routines, took a more active role and even repeated what we were working on during the rest of the week. We became a breeze of fresh air for them, we worked out with our adolescent patients, and we played while exercising with the younger ones. Board games, card games, challenges and even cooking became part of our repertoire, and we had some surprising results.
Since the family were more involved in the process, we had patients who started walking, who diminished their balance impairments and who finally were more active in their daily life. We were also able to reach patients who had dropped off their treatment due to returning to their city of origin, we even had one from another country and who could finally resume his rehabilitation!
As we think of a world after COVID, we have to keep all that we achieved in these hard months. Telerehabilitation is one of those things. We can keep on rehabilitating patients who live far away and are unable to go to our outpatient clinic, those who are in the hospital in isolation, and even intervene children who are in other countries. And more importantly, it works, it helps, and it improves the quality of life from our patients and their families.