Management of Achilles Tear via Telehealth and Remote Programming: A Case Report
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Elisabeth Carter
CoPIs:
Kamil Nykiel
College:
The College of Health Professions and Human Services
Major:
Physical Therapy
Faculty Research Advisor(s):
Caitlin Boyko, Thomas Koc
Abstract:
Telehealth care is increasing in popularity after a significant increase in use during the Covid-19 pandemic. Physical therapists have unique challenges when it comes to implementing telehealth treatment, including inability to provide manual therapy and physical assistance to patients during a session. This case report provides evidence for usage of telehealth when indicated by physical therapists.
The patient was a 34 y/o cis male who presented to PT with complications from an Achilles tear which had occurred six months prior while on a run. The patient was extremely active prior to injury with a full time job and also was a member of the United States Navy. Due to work schedules and military commitments the patient did not have the ability to attend traditional in person physical therapy three times a week. Therefore, the injury went untreated for six months and the patient was unable to complete his military duties. Then, the patient was evaluated via telehealth PT and deemed a candidate for remote programming. Objective findings on evaluation were deficits in ankle dorsiflexion, pes planus, marked differences in single leg calf raise test, and deficits in functional measure scores (Foot and Ankle Measure and Lower Extremity Functional Scale).
The patient completed a therapeutic exercise program in his home or gym with asynchronous communication with the PT as needed. Progress notes were completed at regular intervals to guide exercise progressions. The patient was discharged with full strength and ability to complete all heavy military duties.
The treatment duration was longer than average for the typical healing time for an acute Achilles tendon tear (one year from injury and five months since beginning telehealth PT). This plan of care typically can happen faster with in person care and more frequent visits. However, for this case the traditional model of physical therapy was not possible, and telehealth with remote programming became a successful alternative.