Tele-PT and the Manual Therapist

Posted by Brett Windsor, PT, MPA, PhD on Apr 8, 2020 12:45:18 PM

The Corona virus has coincided with a renewed interest in TelePT. Although there’s no absolute definition of what TelePT is, it’s generally defined as “the provision of rehabilitation across the spectrum of acute, subacute, and community settings at a distance, using telecommunication technology to deliver real-time audio and video conferencing between providers and patients as synchronous telehealth.”1 Although research is relatively minimal, a 2018 systematic review found some positive impact on health outcomes and satisfaction, with some evidence of cost savings in one study.2 Unsurprisingly, the authors recommended robust study prior to drawing any definitive conclusions.

For the manual therapist, telehealth presents real opportunities, but also some obvious challenges. Who better to perform a TelePT evaluation than a fellowship-trained manual therapist? Advanced capabilities in clinical reasoning, diagnosis, listening and observation provide a foundation for a high-satisfaction health care encounter quite likely to result in a positive clinical outcome. Of course, there are challenges — TelePT provides no avenue for the hands-on aspect. So much of what we do depends on touch and feel, truly understanding motion, not to mention the fact that outcomes are simply better when manual therapy and exercise are combined.3

The Corona virus will affect transformational change across society — how we work, how we travel, how we physically interact with each other. Likely, TelePT is here to stay. Now that patients, referral sources and payers have rapidly become familiar with it, barriers to its adoption will continue to break down and TelePT will play a larger part in the physical therapy care episode. There are two primary ways the manual therapist can take advantage of this technology without compromising our effectiveness. Firstly, use it to blend care. Use it to complement, rather than replace, the in-clinic experience. Secondly, build self-care manual therapy techniques into the vast exercise libraries within these platforms.

The questions aren’t all clinical. Is it time to fundamentally change the way we mentor? How about the way we teach? Is it time to think deeply, and reflect, on how we develop expert manual therapists?

As we recover from this pandemic, NAIOMT will be at the forefront in answering these questions and innovating to find better ways to educate, train and develop expert clinicians.

As part of this initiative we're now offering a suite of online courses designed to enhance your clinical reasoning skills across a wide variety of clinical conditions. More information about these new online opportunities here.



  1. Australian Physiotherapy Association. Tele rehabilitation and physiotherapy: position statement. Available at: DocumentsFolder/Advocacy_Position_Telerehabilitation_2009.pdf. Accessed April 6, 2020
  2. Grona SL, Bath B, Busch A, Rotter T, Trask C, Harrison E. Use of videoconferencing for physical therapy in people with musculoskeletal conditions: a systematic review. J Telemed Telecare. 2018;24:341- 355.
  3. Lutz, A. High performing physical therapists consistently use manual therapy regardless of baseline lumbar disability. In Review. 2019.


Topics: tele-pt, telehealth

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