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How to Maximize Post-Surgical Success with Doctors of Physical Therapy

October 18, 2022
Rachel Alfred
Timer  Read Time: 6 minutes

Physical therapy has long been recommended for patients who need to recover from major surgery such a knee or hip replacement, or spinal fusion surgery. Under the guidance of a physical therapist, a postoperative regimen of exercises can increase function, mobility, range of motion, improve strength and stability, reduce pain, and decrease dependence on medication such as opioids. In short, physical therapy can significantly improve your recovery from surgery.

The problem is that many patients don’t stick with their treatments long enough to get the full benefits of rehabilitation. Research shows that non-adherence with prescribed exercises and treatment can be as high as 70% for some patients. One study found that about 8% of patients didn’t show up for any appointments at all, and among those that did, approximately 14% did not complete their course of treatment.

Barriers to adherence include scheduling and transportation difficulties, lack of clinics or providers in a particular area, cost of treatment, inadequate social support and fear of pain or inability to perform the exercises. For many patients, traditional treatment is just too inconvenient.

Fortunately, a digital solution such as Sword Health can overcome many of these hurdles. By allowing members to get better-than-traditional physical therapy in their own homes, on their own time, Sword is dramatically improving how patients heal from surgery.

While innovative technology is part of the solution, it’s the personalized, 1-to-1 treatment from licensed Doctors of Physical Therapy that really makes the difference.

Why personalized care from a Doctor of Physical Therapy is crucial

Musculoskeletal (MSK) issues are medically complex. Achieving sustainable pain relief requires clinically-validated care by trained medical professionals who can provide personalized treatment tailored for each individual.

In a recent statement, the American Physical Therapy Association emphasized this care philosophy, saying that “the practice of physical therapy is performed only by physical therapists.”

In other words, while technology can help, only physical therapists can provide the medical attention necessary for recovery. PTs are trained to identify and treat the root causes of pain. They build trust through empathy and education. They guide patients to make changes that lead to lasting pain relief.

Typical coursework for someone pursuing a doctorate of physical therapy includes anatomy, physiology, biology, chemistry, physics, statistics and psychology, with a focus on the musculoskeletal, cardiovascular, neurological and pulmonary systems. At Sword, our PTs have a minimum of 6-7 years post-secondary education, including a minimum of 1,200 hours of supervised clinical experiences with patients.

All this education and training ensures that members are getting first-rate health care. For this reason, Sword delivers 100% of care through licensed physical therapists (as opposed to a “health coach,” for example). We are the only digital MSK solution on the market to do so.

From the onset, our physical therapists take the time to understand each member’s personal story—their goals, challenges, lifestyle and key metrics such as pain, productivity, depression and anxiety levels. Then they create a personalized exercise plan and are available to the member at any time to answer questions or offer guidance. Our PTs stay connected with the same member for the entire time, adjusting their treatment as necessary several times a week.

This fosters the rapport between clinician and member that is so important for encouraging patient compliance, which ultimately leads to better outcomes.

The importance of early corrective movements

Contrary to popular belief, bedrest after surgery or injury generally doesn’t improve your recovery. The evidence is clear that the faster a patient can mobilize a joint post-operatively, the better the recovery will be. This practice has been implemented in the hospitals with shorter stays, prioritizing movement within therapy departments and ambulation after surgery. Unfortunately, patients don’t tend to follow through on their treatments once they leave the hospital.

With Sword, post-surgery patients can begin physical therapy immediately at home with our Digital Therapist (which includes our wearable sensors and a tablet). They’ll also receive behavioral coaching throughout their treatment to help overcome fear avoidance and anxiety. Studies show that behavioral coaching, or activity prompting, can lead to better compliance.

Additionally, when movements are painful, such as gaining range of motion with knee flexion after a total knee arthroscopy, the patient may compensate by not fully complying with the prescribed exercises. Home exercise programs can’t detect these compensation errors when a therapist is not present, but our sensors can. Swords allows for corrective movement and muscle facilitation early and often, improving overall results.

In fact, Sword is proven to outperform the gold standard of in-clinic physical therapy by 30%.

A comprehensive program that addresses both body and mind

Pain affects your physical and mental health. That’s why a good post-op rehab program must also focus on the emotional and mental side of recovery. Sword helps members overcome both their physical and mental challenges with a holistic approach.

Our program utilizes cognitive behavioral therapy to address the anxiety that often comes with post-operative pain and injuries. At baseline and throughout the treatment, we measure for anxiety, depression and fear avoidance beliefs.

In a peer-reviewed study published in the Journal of Medical Internet Research (JMIR) in July 2022, we were able to demonstrate that our multimodal digital care program can produce substantial improvements in both mental health (anxiety and depression scores) and productivity—even in members with significant depression at baseline.

Members with musculoskeletal issues who also had mild depression were able to reduce their depression scores by 51% and anxiety scores by 41% after using Sword. Members who had moderate depression saw reductions of 29% in depression and 21% in anxiety scores.

By combining physical therapy, behavioral coaching and education with easy-to-use technology, members overcome their post-surgical pain faster and more cost-effectively.

A proven program validated by clinical outcomes

After using Sword, our members see impressive improvement: 62% decrease in pain levels, 49% less medication consumption, and a 42% increase in productivity. About 80% of our members say they feel better or a “great deal” better and a 53% improvement in their ability to carry out daily activities.

We see excellent outcomes for post-op patients as well. A study published in the Journal of Medical Internet Research found that Sword patients achieved 35% better functional outcomes after total hip arthroplasty, requiring 80% less time with a physical therapist, compared to the control group. Patient satisfaction was very high (91% rated their satisfaction as 10/10), with 83% engagement (patients who performed five or more sessions/week).

For members who have undergone a major surgery, there are plenty of barriers to a good recovery: The cost and inconvenience of in-clinic treatment. The fear of pain. The lack of communication with their therapist.

Sword solves all these issues, empowering people to feel better faster with better engagement, better adherence and better outcomes. We want every member to overcome pain and do the things they love with renewed confidence and healthier bodies.

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