September 25, 2020

The CPA has developed the following advocacy statement that guides our approach to interactions with government decision makers during the ongoing COVID-19 pandemic. We want to ensure that governments recognize and value the essential role and contributions of physiotherapists, physiotherapist assistants (PTAs), physical rehabilitation therapists (P.R.T.s) and physiotherapy students working and training in all settings and sectors of health care as they contemplate and implement policies that respond to surges and additional waves of COVID-19.

We are advocating for physiotherapy services in all settings (in-person, virtual, for acute and chronic injuries, illnesses and conditions) to remain available to the patients who need them, beyond only urgent/emergency care during the second and any subsequent waves of the ongoing COVID-19 pandemic.

The COVID-19 pandemic has delayed and restricted access to necessary rehabilitation treatment due to closures and infection control procedures. The pandemic has also magnified existing gaps in access to physiotherapy and other health services across Canada. The CPA is working to get the message through to the federal and provincial governments that physiotherapy services can continue to be offered safely as communities progress through future stages of reopening or restrictions during the COVID-19 pandemic. Care provided by physiotherapy professionals contributes to the health of Canada’s workforce by helping Canadians stay mobile and healthy, and remain active contributors to our economy and communities. The CPA is calling on governments to recognize physiotherapy care in all settings as essential and enable these services to continue throughout the ongoing COVID-19 pandemic.

The CPA’s Statement on “The Role of Physiotherapy in Safely Supporting Canadians During the COVID-19 Pandemic”

Physiotherapy care, whether delivered in the ICU, in clinics, in long-term care facilities, through virtual care, in homes, or in outpatient clinics is essential care. As autonomous self-regulated health care professionals bound by a code of ethics, physiotherapists and P.R.T.s exercise their judgement to act in the best interests of patients and the public to ensure that treatment that could be reasonably delayed is not pursued at the expense of public health precautions. During the pandemic, physiotherapy care has been safely provided across the health system in compliance with all required infection prevention and control measures. Physiotherapy care can and continues to be adapted using alternate delivery approaches, such as telerehabilitation, to manage exposure risks during pandemic restrictions and ensure patients can safely continue treatment.

  • Many Canadians have had to delay treatments due to the mandatory measures enacted to slow the spread of COVID-19. As a result, the health conditions of many have deteriorated, pain has persisted or increased, mental health has worsened, and preventive or maintenance treatments have not been delivered.
  • A growing number of Canadians are living with pain and chronic conditions as a result of the surgical backlog created by the delay/postponement of elective surgeries1,2 during the initial phases of the COVID-19 pandemic response.
  • Post-operative physiotherapy helps patients to recover and return home more quickly.3
  • The care and treatment offered by physiotherapists, PTAs, and P.R.T.s is crucial in keeping Canadians healthy and in preventing the need to access urgent or emergency services in-hospital. In addition, research shows that physiotherapy can delay or prevent the need for elective procedures, such as hip and knee replacements,4 further decreasing the burden on our health care system during a second or third wave. 
  • Care provided by physiotherapists, PTAs, and P.R.T.s with appropriate safety precautions contributes to the health of Canada’s workforce by helping Canadians stay mobile, healthy, and active contributors to our economy and communities. Further, physiotherapy care has not been a source of community spread.
  • Uninterrupted access to physiotherapy care in communities supports the wider health care system’s capacity by easing pressure on hospitals and improving recovery trajectory for patients.
  • In order to keep Canadians safe, physiotherapists and P.R.T.s, who are regulated health care professionals, are trained in, and adhere to, strict infection control practices.5
  • Canadians want to stay healthy and active during the pandemic and the last place Canadians want to be is in-hospital. The early months of 2020 saw a 25 percent decrease in ER visits compared to the same period in 2019.6

The CPA calls on governments to:

  • Ensure that Canadians can continue to access the care and treatment required to maintain optimal health should future shutdowns become a reality. To do this, we ask for recognition of physiotherapists, physiotherapist assistants, and physical rehabilitation therapists as essential health services.
  • Acknowledge that regulated physiotherapy care can be safely provided in-person while managing exposure risk through required infection prevention and control measures.
  • Ensure that Canadians are given the best chance to avoid needing emergency hospital admission or urgent care due to limited access to essential physiotherapy services. The provision of physiotherapy care must not be restricted to urgent/emergency situations only, but must be available to help Canadians avoid the occurrence of urgent/emergency situations.

 


References

  1. Wang, J., Vahid, S., Eberg, M., Milroy, S., Milkovich, J., Wright, F.C., Hunter, A., Kalladeen, R., Zanchetta, C., Wijeysundera, H.C., & Irish, J. (2020, September 1). Clearing the surgical backlog caused by COVID-19 in Ontario: a time series modelling study. Canadian Medical Association Journal (CMAJ). doi: 10.1503/cmaj.201521
  2. COVIDSurg Collaborative. (2020, May 12). Elective surgery cancellations due to the COVID-19 pandemic: global predictive modelling to inform surgical recovery plans. British Journal of Surgery (BJS) Society. doi: 10.1002/bjs.11746
  3. Canadian Physiotherapy Association (CPA). (2012). The Value of Physiotherapy. Retrieved from: https://physiotherapy.ca/sites/default/files/valuePT/cpa_valuept_jointarthroplasty-en.pdf 
  4. Svege, I., Nordsletten, L., Fernandes, L, & Risberg, M.A. (2013, November 19). Exercise therapy may postpone total hip replacement sugery in patients with hip osteoarthritis: a long-term follow-up of randomised trial. Annals of the Rheumatic Diseases, 74 (1), 164-9. doi: 10.1136/annrheumdis-2013-203628
  5. Canadian Alliance of Physiotherapy Regulators (CAPR). (2018, January 31). Core Standards of Practice for Physiotherapists in Canada Now Available. Standard 12: Infection Control. Retrieved from: https://www.alliancept.org/announcement/core-standards-practice-physiotherapists-canada-now-available/
  6. Canadian Institute for Health Information (CIHI). (2020, September 24). COVID-19 resources. Hospitals and emergency departments. COVID-19 hospitalization and emergency department visits. NACRS Emergency Department Visits: Comparison of January to March 2019 and January to March 2020 (XLXS). Retrieved from: https://www.cihi.ca/en/covid-19-resources