Cancer Rehabilitation and the benefits of online physiotherapy

Blog post by Lynn de Dombal, specialist cancer rehab physiotherapist from Rehab Beyond Cancer and PhysiosOnline.

The benefits of online physiotherapy for those affected by cancer 

Hi, my name is Lynn de Dombal, I am a physiotherapist specialising in cancer rehab. I am going to explain to you why I strongly believe Online Physiotherapy Consultations can be so beneficial for patients unable to see their physiotherapist face to face and especially for those requiring Cancer Rehab. 

I will just start with a little bit of background on me, then go on to discuss the benefits of virtual physiotherapy consultations for those affected by cancer and finally explain how they can work for you.

My background 

I worked in the NHS, as a specialist physiotherapist in cancer rehab for 15 years, based at The Institute of Oncology in Leeds.  I left 2 years ago but remained passionate in improving the quality of life of those affected by cancer so I set up Rehab Beyond Cancer which is a specialist cancer rehab service aimed to improve the quality of life of patients living with and beyond cancer.

I also have a nursing background and started my Physiotherapy degree as a mature student after working for 9 years as a staff nurse mainly on surgical wards, but specialising in orthopaedics, plastics, and general surgery.

I am a certified Pinc and Steel Physiotherapist, I feel that by completing this comprehensive cancer rehab course, I have consolidated my knowledge and increased my network of cancer therapists through which I can share experience and knowledge to further improve patients quality of life.

My voluntary work includes being an ambassador for 5K your way, an initiative to encourage those affected by cancer to become more active. I also volunteer with the West Yorkshire and Harrogate Cancer Alliance community panel which help influence decision making and supporting different cancer projects at local level. I also deliver educational talks to cancer support groups and at cancer events.

The impact of Covid 19 has meant that it has been important for my cancer rehab service to adapt by providing online physiotherapy consultations, as a large proportion of my clients have been required to shield. This different way of working has sadly meant that I miss being close to my clients but the positives of providing video consultations have resulted in me being able to reach out to those that have been affected by cancer nationally, allowing them to get individualised rehab from a cancer specialist in a more timely, convenient, accessible and safe way.

Why are Virtual Physio consultations so valuable for those living with or beyond cancer? 

Virtual Physio Consultations are giving cancer rehab Physiotherapists like myself, the opportunity to offer regular support to people diagnosed with cancer, in the comfort of their own homes. Here is why it can work so well

  • Firstly, and most importantly it takes away the risk of infection. The outbreak of Coronavirus has left many people undergoing cancer treatment understandably nervous when attending hospital or clinic settings and who will most definitely feel safer using online physio services. 
  • Regional cancer services often mean long journeys for cancer diagnosis, treatment and follow up. Virtual physiotherapy consultations reduce the additional time, stress and cost caused by traveling. 
  • Cancer patients are frequently exhausted by the effects of their disease and/ or their treatment. To be able to access rehab advice, support and treatment from home is therefore far more effective and convenient at these times. This is especially true, for those with symptoms of fatigue, pain, or shortness of breath.   
  • Often cancer specialist rehab is only available at regional cancer centers and not available more widely. Therefore, having virtual consultations with a specialist cancer physiotherapist means receiving cancer rehab is less of a postcode lottery and available to anyone, anywhere and at anytime along your cancer pathway. 
  • Having faster access to professional support that can be obtained by using online physio can massively reduce unnecessary anxiety around new symptoms and/or physical deterioration. For example, you may have a lot of anxiety around returning to exercise or work, or you may be worried something is painful or does not move well.  The early contact with a physio specializing in cancer rehab can help allay your anxieties sooner and ultimately lead to a better outcome. I can refer onwards to your oncologist, GP or other support networks if it is a concern that needs input from other professionals.
  • Often rehab is only considered at the end of treatment, but evidence shows that by seeking access to rehab advice and support either before or during your treatment can hugely reduce treatment side effects and improve cancer outcome as well improving quality of life. Physical impairments that might be relatively easily addressed if detected early or indeed avoided with early specialist education and advice, can become very difficult to treat and less reversible if they have progressed over weeks and months. 
  • Socially it gives you someone else to talk to, outside of your family/bubble, who understands your journey when you are trying to keep your number of contacts to a minimum. Carers and family are often under considerable pressure to maintain support and remain positive.  Having a great rapport with someone professional that understands your condition can help reduce the pressure on your family whilst increase the amount and wealth of your support network. This is especially valuable at a time when you may be feeling more isolated and vulnerable than ever.
  • Seeing you in your own home environment further enhances our holistic approach. Seeing how you function, and your social situation means that your treatment can be even more personalized and specific to your equipment, adaptations, and the support of your family and/or carers. Having the holistic advice, support, and guidance on how to improve your wellbeing, as and when you need it, helps empower you better in your self-management. Taking back some control is vital psychologically but also improves your outcome physically.

How does online physiotherapy work? 

  • The online consultations enable you to discuss your symptoms, questions, and concerns with a Cancer Rehab Physiotherapist like myself in the comfort of your own home, using either your laptop, ipad or smartphone. I will have made sure you are happy using the device you have chosen and we can have a trial practice. All this will have been discussed over the phone beforehand
  • A lot of information is gained from hearing your story which can be done just as well on virtual consultation. I will ask a series of questions about your symptoms and safely guide you through a series of tests and movements to diagnose your condition. 
  • I can then develop a personalised recovery plan set around your individual goals that you specifically want to achieve. I can instruct you on what to do and importantly what to avoid, also suggesting alternatives to make life easier.  This may also include how other people you live with can help and support you with your rehab. Such techniques might include massage, stretches and some assisted or passive movements. 
  • It is a really important to continue with your rehab and not lose the gains you have made. I can check you are doing your exercises correctly and progress them. I can then advise you continue in my exercise group if appropriate to further increase your confidence, strength, exercise tolerance and to provide a support network. This is so important from a physical and mental health point of view. I may also refer you to services more local to you as and when we both feel it would be appropriate.

It is more important than ever that people affected by cancer are supported in maintaining their function and wellbeing during this challenging and ever evolving time. The good news is that online Physiotherapy consultations are enabling specialised Cancer Rehab Physiotherapists  like myself to continue to provide vital support to all of you irrespective of where you live, where you are along your treatment pathway or whatever your problems may be. 

Lynn De Dombal:

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