JMIR Publications

ABSTRACT

Background:

Subsequent to the onset of the COVID-19 pandemic, telerehabilitation (TR) has been expanding to address the challenges and risks of in-person delivery. It is likely that a level of TR delivery will continue post-pandemic because of the advantages it affords, such as reducing geographical barriers to service. Many pandemic-related TR initiatives were put in place quickly. Therefore, we have little understanding of current TR delivery, the barriers and facilitators, and how therapists anticipate integrating TR into “current practice”. Knowing this information will allow for incorporating competencies specifically related to the use and provision of TR into professional profiles and entry-to-practice education, thereby promoting high quality TR care.

Objective:

This study obtained a descriptive overview of current TR practice among rehabilitation therapists in Canada and the Netherlands and identified perceived barriers and facilitators to practice.

Methods:

A web-based cross-sectional survey was conducted with occupational, physical, and respiratory therapists and dietitians in Canada (in French and English) and the Netherlands (in Dutch and English) between November 2021 and March 2022. Recruitment included advertisements on social media platforms as well as email invitations facilitated by regulatory and professional bodies. The survey included demographic and practice setting information; whether respondents delivered TR and if so, components of delivery; confidence and satisfaction ratings with delivery; and barriers and facilitators to use. TR satisfaction and uptake was measured with the Telehealth Usability Questionnaire (TUQ) and the modified Technology Acceptance Model (mTAM). Data was first summarized descriptively and then comparisons were conducted between professions.

Results:

A total of 723 survey responses were received, mostly from Canada (92%, n = 666) and the majority from occupational therapists (60%, n = 434). Only 28% reported receiving specific training on TR, with 1% (n=9) indicating it was part of their professional education. About 20% reported not using TR at all, while the majority had been using this approach between one and two years. Services delivered were primarily teleconsultation and teletreatment with individuals. Respondents offering TR were moderately satisfied with their service delivery and found it to be effective; 90% indicated they were likely to continue offering TR post-pandemic. Technology access, confidence and set-up were rated highest as facilitators, while technology issues and the clinical need for physical contact were the most common barriers.

Conclusions:

Professional practice and experience with TR were similar in both countries, suggesting the potential for common strategic approaches. The high prevalence of current practice and strong indicators of TR uptake suggest therapists are likely to continue TR delivery post-pandemic; however, most therapists felt ill-prepared for practice and the need to target TR competencies during professional and post-professional education is critical. Future work should explore best practice for preparatory and continuing education.