A survey of the experiences of delivering physiotherapy services through telerehabilitation during the COVID-19 pandemic

Introduction: Physiotherapy services have been typically provided in-person since the profession usually involves a therapist providing hands-on assessment and treatments. The COVID-19 pandemic provided an opportunity to study physiotherapists' adaptation to telerehabilitation (phone or videoconference).

Objective: This study aimed: (1) to explore how physiotherapists adapted to the transition to delivering telerehabilitation, (2) to assess physiotherapists' perceptions of implementing telerehabilitation, and (3) to identify the challenges and facilitators of delivering telerehabilitation.

Methods: This study used an online survey distributed to physiotherapists within a large Canadian health authority. Closed-ended questions were analyzed with descriptive statistics.

Results: Seventy-five physiotherapists responded and data were collected. Compared prior to the pandemic to time during the pandemic, the use of a phone for delivering physiotherapy increased from 24.0% to 73.3% of physiotherapists while videoconference increased from 5.3% to 77.3%. Overall, the physiotherapists found videoconference to be a more effective delivery method than phone. Less than half felt that they could use videoconference to effectively treat pain (49.3%), upper extremity function (40.0%) or strength/range of motion (48.0%). Only 29.3% felt that they could effectively treat walking balance or mobility by videoconference. Technical barriers were identified with client comfort with the equipment reported by 90.7% of physiotherapists and positioning of the webcam by 76.0% of physiotherapists. A large proportion of physiotherapists agreed that they would continue the practice of telerehabilitation via phone (54.7%) and videoconference (68.0%).

Conclusion: The pandemic resulted in a dramatic shift to telerehabilitation for a profession that typically provides hands-on assessments and treatments. While there was increased uptake of telerehabilitation, many physiotherapists questioned their effectiveness using telerehabilitation to undertake activities that traditionally involve manual treatments or hands-on guidance/supervision. However, physiotherapists were committed to continuing telerehabilitation to meet patients' needs after the pandemic.