Wounded Israeli soldiers rehabbed remotely with tablets

For centuries, physicians insisted on hands-on care of their patients. Without carrying out a physical examination and speaking to them face-to-face, they couldn’t really treat them. Physiotherapists, occupational therapists, psychologists, and psychiatrists obviously had to be in the same room.

But with the development of telemedicine, especially as a result of the COVID-19 pandemic, this is longer true. And now, with the huge number of Israeli soldiers and civilians who need physical and psychological rehabilitation and too few facilities and personnel to accomplish this, tele-rehabilitation was sure to follow.

Haifa’s Bnai Zion Medical Center (BZMC), the government- and municipality-owned hospital – that many patients from outside the major northern city had never heard about before – has 450 inpatient beds. Established in 1922 by the Hadassah Medical Organization and initially known as the Hadassah Hospital in Haifa, it was the first Jewish hospital in the city.

The city’s better-known and much larger medical center, which has received the most publicity until now, is the Rambam Health Care Campus, a tertiary-level health care facility that has doubled its capacity from 1,100 to 2,200 beds above and below ground due to constant rocket attacks and the need to treat northern residents affected by them. 

BZMC IS now coming into its own due to the war and the needs for specialized and unusual rehab. With a workforce of 1,800 staffers, it has about 142,000 patient visits per year, and its emergency department receives 65,000 of them. About 14,000 surgical procedures are performed annually, and the obstetrics department performs 3,500 births per year.

Bnai Zion’s main focus is offering orthopedic, neurological, and cardiological rehabilitation, as well as occupational and physical therapy. Physicians and staff, who are Christian and Muslim Arab, Druze and Jewish, work together every day as a unified team to bring medical care to every patient who enters the hospital, regardless of their beliefs or background. The medical center is affiliated with Technion – Israel Institute of Technology and serves as a teaching hospital for its students.

Immediately after the murderous Hamas terrorist attack on the south, BZMC Director-General and former chief medical officer of the Israel Navy, Dr. Ohad Hochman, opened the only soldier rehabilitation hospital department in the North in response to emergent medical needs.

A year before the incursion, the medical center established a specialized center capable of handling the potential medical damage from atomic, chemical and biological warfare. In 2023, an integrative-medicine treatment clinic was set up to provide a response to medical staffers exposed to the many severely wounded and emotionally traumatized patients being treated at the hospital, including those having symptoms of acute post-traumatic stress disorder (PTSD) as a result of war and terrorism.

Dr. Amihai Levkoviz is the hospital’s senior rehab physician who is in charge of neurological movement disorder patients. He also specialized in sports medicine – including being involved with Israel’s swimming paralympics team – as well as with sexual medicine so he could help patients who keep such problems to themselves due to embarrassment.

Born in Haifa, he studied medicine in Romania and completed his specialization at BZMC in 2014. Today, he heads a team of 60 people including doctors, nurses, physical and occupational therapists and a psychologist.

AMONG THE treatments he and his colleagues offer are neurological rehabilitation after damage to the central nervous system including rehabilitation after stroke, traumatic brain injury and tumor removal, multiple sclerosis, Parkinson’s disease and spinal-cord injuries; rehab after injuries to the peripheral nervous system and musculoskeletal injuries; orthopedic rehab for amputees immediately after amputation up to complications with the use of a prosthesis; rehabilitation after limb fractures, and rehabilitation after joint replacements; reduction and treatment of spasticity in the limbs; injection of botulinum toxin (Botox) into muscles; rehab after prolonged hospitalizations and serious illnesses, extensive decrease in strength and muscle mass and a decrease in general endurance; counseling and guidance in pain rehabilitation; PRP injection – obtained from a patient’s own blood and centrifuged to increase the concentration of platelets to treat orthopedic injuries and conditions – and hyaluronic acid injection into the joints. 

The hospital is now treating 120 wounded and injured soldiers, Levkoviz told The Jerusalem Post in an interview. This places an extra layer of stress on an already stretched countrywide healthcare system. Because of the patient overflow, after patients have been treated in the hospital itself, the tele-rehab center makes it possible for them to stay in the comfort of their homes with their support systems while still receiving high-quality physical and psychological care.

Half of the patients are reservists

Half of the patients are reservists and the rest are in the standing army, said Levkoviz, who himself served in Gaza with paratroopers last December. “Most young soldiers are eager to return to the front and cut short the rehab even though they need it,” he said, “but reservists with families are more settled and value the benefits of this treatment.”

He recalled a 33-year-old officer in the Givati Brigade who was hit in the socket of his eye. The surgeons decided not to remove it because doing so would cause more serious damage, and it was left there. He suffered from chronic pain, and his cognitive abilities were not normal. He couldn’t return to army service, but managed to study in college. “It’s difficult for him to get to the hospital, so we included him in tele-rehab.”

Levkoviz has treated male and female soldiers who have been hurt physically and also suffer from PTSD. Tele-rehab is provided with computer tablets distributed free to patients that they use from home two or three times a week, receiving 40 minutes each of all kinds of individual therapies. They start with 16 treatments that can be doubled. “We don’t work with groups. Each patient receives videos to practice, and they are very enthusiastic. Those with PTSD are especially eager to get help from home. Some of the soldiers have started to study at the Technion from afar.”

YUVAL LEVI, a 24-year-old Golani soldier in the armored division who was moved to the Haifa area because it was impossible due to missiles to live at his family home in Shlomi, suffered severe injuries to his right arm in January while fixing a tank. The accident sent him to Soroka Medical Center for a month, and then he was transferred to BZMC for rehabilitation.

BZMC’s Friends Association works to raise the necessary resources and support for the development and advancement of the hospital and to purchase medical equipment and advanced technologies. Since the beginning of the Iron Swords war, the association’s work – together and thanks to its partners and supporters here and abroad – has made a crucial difference in enabling the hospital to upgrade its services and lifesaving equipment.

Levkoviz’s patients constantly send him messages of thanks. “I arrived a frustrated, depressed, hopelessly disabled man at a rehabilitation clinic. I came out a man full of hope and the ability to get out of the situation I was in. One day, my mental state was very difficult. Amihai worked a long shift of 24 hours, but he demanded to see me before he went to rest. He sat down to talk with me in his free time for almost an hour. He thought I took it for granted. But this moment moved me and I learned a lot from it. I came to him in a bad condition, and I got out of there as something else, which others define as a medical miracle,” one said.

“Amihai is one of the best doctors who treated me,” stated another. “The responsibility, the patience, the behavior, the professional and human honesty, really in all respects. A unique person and doctor!”

“He treated us with great professionalism,” declared another admirer. “Every question was answered with a humility and dedication that we have never encountered before. We arrived with anxiety and left strengthened. May every doctor treat every patient as an individual and as specially as he does.”

After the war is over, Levkoviz said in conclusion, his department will not only continue to treat soldiers but also civilian patients not hurt in the conflict, using tele-rehab as a regular tool to improve their conditions.