Interview with Elizabeth, physiotherapist
How did you become a physiotherapist?
I have always been attracted to the health professions. I myself had some problems with a knee when I was younger, which led me to consult physiotherapists. To become a physiotherapist in the Nancy area, there were 50 places for 1,500 candidates at the time. I was 17 years old when I took the exam, and I passed it. I worked from 1983 until two months ago, when I stopped my activity to become a young retiree.
Can you tell us about your career?
I started as an assistant associate in a law firm in 1983 and then opened my own practice in 1984. At first, I set up on my own, then the business grew. I was joined by assistant associates, a partner, and my secretary, who was my right-hand woman for 27 years.
I worked at least 12 hours a day, 6 days a week, for 42 years. I arrived at the office around 6:30 in the morning and left around 8:30 p.m., with a lunch break of 30 to 45 minutes maximum.
I also made home visits three times a week: on Tuesday afternoons, Thursday mornings, and Saturdays from the end of the morning. Sometimes more so, when a colleague had to be replaced at short notice.
If someone had told me ten years ago that I would have so many patients in my last years of practice, I wouldn’t have believed it. The number has risen to about 200 patients per week, while continuing home visits. These were often elderly patients or patients with serious neurological pathologies, such as Parkinson’s disease, who could no longer move.
A few years before retirement, a nursing home was set up a kilometre from my practice. I thought it would relieve my business, but it didn’t. So I decided to stop, so I could rest. One thing is for sure: I loved my job!
How do you explain this high demand?
I would say that it is multi-factorial… I am in a department, the Vosges, where the density of health professionals is not very high. There is a lack in some areas. At the same time, the population is aging, and the demand for care is increasing.
My practice has also benefited from excellent word-of-mouth. I spent at least 20 minutes with each patient individually, which was not always the case elsewhere. As a result, people come, doctors send their patients…
A patient who needs to do muscle strengthening can work alone while the practitioner can take care of another patient at the same time. But for certain pathologies, the act must really be individualized. I’m thinking mainly of neurology and all the patients who come for an infection, or a serious pathology.
What changes in the profession have you witnessed?
The profession has become much more feminized. 40 years ago, it was very masculine. Now she is mostly female. Today, it is still mainly women who take care of children in the home and inevitably this has an impact on the possible workload.
The younger generation, and we can understand it, sometimes refuses to make home visits or certain treatments, because these acts are very poorly paid by the Health Insurance. We are talking about home visits at 2 euros… If you hand 2 euros to an electrician, I doubt that he will come back to your house a second time! (laughs). It’s also particularly stressful. Over the last few years, going around my patients was almost with the stopwatch in hand, telling myself “if you chose to take ten minutes with a patient because she wasn’t in the mood, you’ll have to try to get those ten minutes back elsewhere”.
And then there is also the arrival of new technologies, including virtual reality, which helps us a lot. I think it’s going to get bigger. It is approached more systematically in physiotherapy schools and I am convinced of its interest for our patients. I myself trained the trainees and collaborators in VR. They are always very interested, especially since it is also a real plus in their learning.
How did you integrate H’ability’s virtual reality solution into your practice?
It was through my reading that I discovered that virtual reality could be used by physiotherapists and rehabilitation in general. I subscribe to Kiné Actualité, I read Kiné Scientifique, I participate in a few congresses or assemblies… It allowed me to learn a lot, and to be a bit of a local pioneer in the field.
What motivated me to invest in this equipment were my patients.
Since we were talking about home visits: when you visit patients who are too old or suffering from serious pathologies, you are stuck in a structure that is not yours, in a very restricted environment. This means that we quickly arrive at exercises that are a little repetitive and monotonous. Virtual reality has allowed me to bring something else. For me, it is an excellent complementary tool.
How do patients react to the solution?
So I had all the possible and imaginable reactions. Some people would immediately say: “Really? Great, awesome!” Others were more reluctant. I’m thinking of a patient, suffering from Charcot’s disease, who didn’t want to try the helmet at all. With the help of his daughter, we managed to offer him a try. Afterwards, when I didn’t have the equipment with me, he would tell me: “Oh well, you didn’t bring him? It’s a shame, it really changes us, it’s really good!”
This patient I am talking about has Charcot’s disease. It is a progressive paralysis that evolves very quickly. He was a prisoner of his whole body but still had relative mobility of the upper limbs. Virtual reality made him escape, to let off steam. As he still had the motor skills of his upper limbs, I made him play boxing games, for example. On this type of game I could see that he was a little angry, forgetting his chair, and thanks to the helmet.
What progress have you seen in other patients?
There are many, but I immediately think of one patient in particular. A lady with major brain degeneration. She no longer recognized anyone and had very limited mobility. My field of action was just as important. I could only do classic mobilizations to maintain the condition of his lower and upper limbs.
Then I decided to take this lady on short trips. With the helmet on my head, I would send him travel sessions (to the sea, to the mountains, etc.). One day, when her daughter was also present, I took her mother to a virtual educational farm. She started to turn her head in all directions, actively looking for the animals hidden in the farm… when she normally no longer had a head rotation.
At the end of the session, this lady even kissed her daughter. Something she hadn’t done since… for a very long time. That’s it. When we put the helmet down, we were both in tears. It was an extremely moving movement that I will never forget.
We think it awakened an emotion, a memory in her. We realize, like there when we do the travel games, that it can actually awaken something very intimate in the person and make them react. I think even for people who have degeneration or who show advanced senility and so on, virtual reality can be interesting to try.
Have you also noticed positive effects against kinesiophobia, especially in children?
So there, children, it’s indisputable. That is to say, the day you tell them “today, we’re going to work a little less traditionally” and you put the helmet on their heads, they are the happiest in the world.
Kinesiophobia is something that is very interesting to fight with VR. We manage to capture the patient and he forgets his disability or his concern. In the context of mirror therapy with hemiplegic people, for example, it works very well.
I think of a kid who suffered from a braquial plexus paralysis at birth. He had after-effects of this paralysis and rehabilitation was necessary to mobilize him. Systematically, we had to do a little reinforcement, a little bit of counter-resistance,… really specific things in analytics that he didn’t particularly like. In fact, when I retired, he gave me a cactus! Magnificent, but a cactus nonetheless! His message was in all subtlety! (laughs).
Making the children play allows you to swallow the length and repetition of the physiotherapy sessions. It’s a great tool for them. When they went out, the kids said “I’m going to tell my friends that I did virtual reality at the physiotherapist’s office” and it’s great.
Conversely, has H’ability allowed you to help elderly patients maintain their autonomy?
Oh yes, yes. I am thinking of a patient, a little under 80 years old, whose doctor had prescribed strengthening. This man had become depressed following the loss of his wife. He had lost his balance and was at significant risk of falling. In addition to traditional methods, we were able to improve his balance and the fight against fall prevention with games.
I’m thinking of exercises like football or the one where you have to catch stars. From the moment you make someone play, grab things from above,… For people aged 80 and over, it is sometimes gestures that they no longer dare to do or only with a cane, for fear of falling.
While in this context, it is a reassuring environment where they can make any gesture, they know they are safe under the benevolent eye of the practitioner.
Now retired, what memory remains in your mind?
It’s difficult. There are many of them. But I will really keep the recognition of patients, which is permanent. I have been told so much thank you. As my last day of activity approached, I kept being spoiled. I was spoiled with flowers, chocolate, books and everything. My daughter, who came to the office one evening, saw the boxes of chocolates piling up and even told me “the chocolatier made his turnover for the month with you!” (laughs).
Really, I have a huge, enormous gratitude.
And then there were all these patients I talked about and others who touched me enormously. This gentleman with Charcot’s disease who put on his helmet with a big smile… These are memorable memories that I will keep for the rest of my life.