The brilliant Maryke Louw joins us today to answer your questions about online consultations. Maryke has been providing video assessments for 6 years and has been running an online only service since 2019. She’s also a great physio with years of experience and someone I’ve had the pleasure of working with to treat elite athletes. Make sure you follow Maryke on Twitter via @SportPhys and check out her website and youtube channel.
1. How can we do tests that might require closer assessment such as muscle strength or neuro tests?
You can’t do all the tests that you would do in a physical clinic. I always triage my online patients if I feel, from doing their subjective interview, that there is a high likelihood of serious injury or red flags or serious/progressive neural disease.
For all other conditions I tend to get my patients to replicate the test movements actively. You are a bit limited with performing neuro tests, but you can still get a general idea by talking the patient through it. I’ve generally found that if I explain to a patient what I would like to test and why, most of them are really good at making observations.
It becomes a bit more difficult when you have a patient who is catastrophizing because you have to be careful not to increase their level of concern. So make sure you choose your words carefully – too much detail and information could be a very bad thing in those cases. I sometimes even leave certain tests out if I feel that…