Facilitators and Barriers for the Adoption and Use of Telerehabilitation in Outpatient and Community Settings During the COVID-19 Pandemic: A Survey of Ontario Physiotherapists

To describe the impact of COVID-19 on the adoption and use of telerehabilitation (TR), and to identify facilitators and barriers of the provision in Ontario physiotherapy outpatient/community settings. A cross-sectional design, web-based survey was disseminated to Ontario physiotherapists working in outpatient/community settings. Descriptive statistics were used for data analysis. Responses from 243 physiotherapists were included in the analysis. Respondents reported increasing and initiating TR to maintain continuity of care and limit patient COVID-19 exposure. Facilitators for adopting TR were physiotherapists’ attitudes and access to technology, convenience and ease of scheduling sessions, and perceived patient satisfaction and comfort in their home environment compared with in-person care. Patient related barriers for adopting TR perceived by respondents included patients’ attitude, suitability and ability to address their needs, ease of adoption, and internet connectivity. More than 50% of respondents perceived that financial factors did not influence TR adoption. Physiotherapists increased their use of TR through the COVID-19 pandemic. Effective implementation of TR should include both patient and physiotherapist education, and best practice guidelines on implementation of TR in order to create a hybrid model of care that would better address the patient’s needs.