By Carol A. Cates, MSN, MBA, RN
Chief Nursing Officer
Odessa Regional Medical Center
I love history. Historical documentaries are my favorite things to watch on TV, and I love to read about history as well. I think the reason I love that so much is because it reminds me that while there is a great deal of evil in the world, there is also a huge capacity in people to adapt and overcome and progress towards something better. Maybe it’s naïve of me to think so, but I truly believe the people who want to do good and make the world a better place far outnumber those that are evil, we just don’t hear much about the good because it doesn’t make headlines.
One of the things that keeps my faith in good strong is how as humans, we somehow always find a way to make good come from bad. Yesterday I read an article that reinforced that belief. It talked about how a technology change that came out of necessity during the COVID pandemic is making a big positive impact on recovery for stroke patients. Since stroke is the number one cause of disability in the U.S., positive impacts on stroke recovery have very big implications in improving lives. That technology is virtual rehab.
During COVID, virtual doctor’s visits went from an emerging technology to a staple for many health care providers almost overnight. That technology allowed physicians, nurse practitioners, and physician assistants to continue to see patients during lockdown without concerns of spreading the virus for routine or chronic conditions. While many things still need the hands-on approach of a traditional visit, virtual visits have been a great adjunct for many health care provider offices because of the flexibility it allows. Out here in the Basin, I think virtual visits services will make the biggest difference for those folks who live in our more rural areas and often have to drive hours to see a health care provider.
It’s not just health care provider offices that are hopping on the virtual visit bandwagon. It’s other healthcare specialties as well. One of those is virtual rehab. Virtual rehab is physical therapy, occupational therapy, and/or speech therapy using FaceTime-like technology.
The University of British Columbia’s health care system (in Canada) started using virtual rehab as a way of working with their stroke patients who needed outpatient physical therapy during lockdown. Once you get about 100 miles away from the U.S. border, British Columbia is a lot like West Texas in terms of population density. Just like us, they have a whole lot of space and not many people. They found that those virtual rehab visits were especially popular with the patients who lived out in those rural areas. But, they worried about those patients not seeing the same benefit as patients who had in-person visits once the strict isolation precautions of COVID were over. In order to find out, they began a study.
The results of this study were very interesting. It was a small study so further research is probably needed to make sure the results they found hold true in other places, but their results are so encouraging, I still wanted to share. In this study, the researchers looked primarily at 32 patients, all who had a stroke in the last 18 month and who had their ability to walk affected. The participants all showed improvement in mobility and strength, and they all made progress in reaching goals. The thing that really caught my attention though was that the people who were virtual maintained their progress as well or better than those who had in-person rehab services. The researchers felt it was because the emphasis on self-management is higher with virtual rehab because the medium is in many ways built around self-management.
Neuroscience is learning more and more each day about how our brains adapt after strokes and other brain injuries. A huge part of that is how we build new pathways for the tasks we do. In general, building those new pathways takes a great deal of time and repetition. That’s why it so important that people learn self-management in rehab, so they can continue to build those new pathways even after the formal rehab phase of their recovery is completed.
I just love seeing these little peeks into the future where something good is developed from something bad, and it just continues to build good. Virtual rehab could be one of those things, and like rural British Columbia, it might be something where we in West Texas don’t just get the self-management benefits, but the access to healthcare benefits for our most rural populations as well.
As a final note, I want to remind everyone, most strokes are reversible, if the person seeks care quickly. If a stroke is reversed, rehab is not as needed. Please, if you or someone you love is experiencing stroke symptoms, call 911!
The best way to remember stroke symptoms is the algorithm BE FAST. B-balance, sudden loss of balance or dizziness, E-eyes, sudden changes in vision, F-face, sudden facial drooping, especially on one side or sudden severe headache, A-arms, sudden weakness or tingling in arms or legs, especially on one side, S-speech, sudden difficulty speaking or confusion, and T-time. Time to call 911. Don’t wait, don’t delay, don’t wait to see if it goes away. Call 911 immediately.
With strokes time is critical and the window to reverse is only a few hours. Reversing a stroke is way, way, better than any treatment to recover from a stroke, no matter how great that treatment technology is.
