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Sia LL, Sharma S, Ing JBM, Kumar S, Singh DKA. Physiotherapists' perceptions, readiness, enablers, and barriers to use telerehabilitation: A scoping review. J Back Musculoskelet Rehabil 2024:BMR240009. [PMID: 38905032 DOI: 10.3233/bmr-240009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/23/2024]
Abstract
BACKGROUND The growing use of telerehabilitation within the healthcare community has garnered substantial attention. In congruence with other healthcare fields, examining perceptions, barriers, and facilitators assumed paramount significance in the continuation and fortification of telerehabilitation practices among physiotherapists. OBJECTIVE In this scoping review, we aimed to systematically map the literature on the perceptions of physiotherapists as well as the barriers and enablers of telerehabilitation in their daily practice. METHODS The five-stage methodological framework recommended by Arksey and O'Malley (2005) was used for this scoping review. In the framework, eight databases were searched using key search terms such as "telerehabilitation", "physiotherapists", "readiness", "enablers" and "barriers" All findings were organised into perceptions and readiness, enablers, and barriers. RESULTS Fourteen articles met the inclusion criteria and were categorized as: (1) perception and readiness, (2) enablers, and (3) barriers. In the perception and readiness category, new trends in healthcare, advancement in physiotherapy practices and the benefits to clients were identified. The enablers identified included prior training, personal experience, familiarity with technology, functional equipment and space, and client selection. The barriers to the adoption of telerehabilitation in physiotherapy practice are pinpointed to poor technology, communication hurdles, limited availability, lack of familiarity, and client-related concerns. CONCLUSION While initial evidence suggests a generally positive perceptions it is important to consider both facilitators and barriers when understanding adoption. This review's findings revealed a wide research gap, with unequal weightage towards barriers compared to enablers, and highlights the need for further research. Developing telerehabilitation guidelines that cater to both physiotherapists and clients is necessary.
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Affiliation(s)
- Lee Lee Sia
- Physiotherapy Program and Centre of Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Miri Hospital, Ministry of Health Malaysia, Miri Sarawak, Malaysia
| | - Shobha Sharma
- Speech Sciences Program and Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Janet Bong May Ing
- Physiotherapy Program and Centre of Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Sarawak General Hospital, Ministry of Health Malaysia, Jalan Hospital, Kuching Sarawak, Malaysia
| | - Saravana Kumar
- Allied Health and Human Performance, Level 8, Centenary Building, City East Campus, University of South Australia, Adelaide, SA, Australia
| | - Devinder Kaur Ajit Singh
- Physiotherapy Program and Centre of Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Munce S, Andreoli A, Bayley M, Guo M, Inness EL, Kua A, McIntyre M. Clinicians' Experiences of Implementing a Telerehabilitation Toolkit During the COVID-19 Pandemic: Qualitative Descriptive Study. JMIR Rehabil Assist Technol 2023; 10:e44591. [PMID: 36897634 PMCID: PMC10039414 DOI: 10.2196/44591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 02/01/2023] [Accepted: 02/27/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND Although the COVID-19 pandemic resulted in a rapid implementation and scale-up of telehealth for patients in need of rehabilitation, an overall slower scaling up to telerehabilitation has been documented. OBJECTIVE The purpose of this study was to understand experiences of implementing telerehabilitation during the COVID-19 pandemic as well as using the Toronto Rehab Telerehab Toolkit from the perspective of rehabilitation professionals across Canada and internationally. METHODS The study adopted a qualitative descriptive approach that consisted of telephone- or videoconference-supported interviews and focus groups. Participants included rehabilitation providers as well as health care leaders who had used the Toronto Rehab Telerehab Toolkit. Each participant took part in a semi-structured interview or focus group, lasting approximately 30-40 minutes. Thematic analysis was used to understand the barriers and enablers of providing telerehabilitation and implementing the Toronto Rehab Telerehab Toolkit. Three members of the research team independently analyzed a set of the same transcripts and met after each set to discuss their analysis. RESULTS A total of 22 participants participated, and 7 interviews and 4 focus groups were included. The data of participants were collected from both Canadian (Alberta, New Brunswick, and Ontario) and international sites (Australia, Greece, and South Korea). A total of 11 sites were represented, 5 of which focused on neurological rehabilitation. Participants included health care providers (ie, physicians, occupational therapists, physical therapists, speech language pathologists, and social workers), managers and system leaders, as well as research and education professionals. Overall, 4 themes were identified including (1) implementation considerations for telerehabilitation, encompassing 2 subthemes of "infrastructure, equipment, and space" and "leadership and organizational support"; (2) innovations developed as a result of telerehabilitation; (3) the toolkit as a catalyst for implementing telerehabilitation; and (4) recommendations for improving the toolkit. CONCLUSIONS Findings from this qualitative study confirm some of the previously identified experiences with implementing telerehabilitation, but from the perspective of Canadian and international rehabilitation providers and leaders. These findings include the importance of adequate infrastructure, equipment, and space; the key role of organizational or leadership support in adopting telerehabilitation; and availing resources to implement it. Importantly, participants in our study described the toolkit as an important resource to broker networking opportunities and highlighted the need to pivot to telerehabilitation, especially early in the pandemic. Findings from this study will be used to improve the next iteration of the toolkit (Toolkit 2.0) to promote safe, accessible, and effective telerehabilitation to those patients in need in the future.
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Affiliation(s)
- Sarah Munce
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, Toronto, ON, Canada
| | - Angie Andreoli
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Mark Bayley
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, Toronto, ON, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Meiqi Guo
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Elizabeth L Inness
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Ailene Kua
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - McKyla McIntyre
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, ON, Canada
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Leochico CFD, Rey-Matias BMV, Rey-Matias RR. Telerehabilitation perceptions and experiences of physiatrists in a lower-middle-income country during the COVID-19 pandemic. PM R 2021; 14:210-216. [PMID: 34585855 PMCID: PMC8661588 DOI: 10.1002/pmrj.12715] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 08/05/2021] [Accepted: 09/24/2021] [Indexed: 01/14/2023]
Abstract
Background The COVID‐19 pandemic catalyzed the adoption of telerehabilitation in various health care settings. However, there was neither a preexisting national guideline in the Philippines nor an internationally agreed upon standard for telerehabilitation. The literature lacks nationwide studies documenting how physiatrists perceived and experienced telerehabilitation during the pandemic. Objective To determine the perceptions and experiences of physiatrists in the Philippines regarding telerehabilitation. Design Online survey originally developed by the authors with inputs from local experts in telehealth or telerehabilitation. Setting Nationwide, involving board‐certified physiatrists practicing in the Philippines. Participants Fellows of the Philippine Academy of Rehabilitation Medicine (PARM) (N = 259) with Internet access. Main Outcome Measures Self‐reported telerehabilitation knowledge, skills, and experience; key concerns; preferred clients, service offerings, and methods (technology, duration, charging). Results The respondents (n = 161; 62.2% response rate) had a mean age of 48.1 ± 9.6 years, were mostly female (57.8%), and mostly practiced in private hospitals and urban settings. The majority reported inadequate telerehabilitation knowledge (61.5%), skills (58.4%), and experience (72.1%). The most common sources of telerehabilitation knowledge were colleagues (52.8%), PARM (51.6%), and telemedicine‐related websites (41.6%). Most of the respondents preferred to conduct telerehabilitation with former patients over new ones and prescribe telerehabilitation programs for physical, occupational, psychological, and speech‐language therapy but not for swallowing therapy. Videoconferencing was the most common telerehabilitation method. More than half of the respondents charged lesser fees for telerehabilitation compared to in‐person consultations. Although the majority recognized the need for telerehabilitation, their key concerns included the lack of thorough patient examination and medicolegal liability issues. Conclusion Despite their limited baseline knowledge, skills, and experience regarding telerehabilitation, many physiatrists in the Philippines learned to adopt this service delivery method during the pandemic. Their perceptions and experiences could be used in formulating practice‐based guidelines and strategies to improve the conduct of telerehabilitation in the country.
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Affiliation(s)
- Carl Froilan D Leochico
- Department of Physical Medicine and Rehabilitation, St. Luke's Medical Center, Quezon City, Philippines.,Department of Rehabilitation Medicine, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | | | - Reynaldo R Rey-Matias
- Department of Physical Medicine and Rehabilitation, St. Luke's Medical Center, Quezon City, Philippines.,Department of Rehabilitation Medicine, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
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Niknejad N, Ismail W, Bahari M, Nazari B. Understanding Telerehabilitation Technology to Evaluate Stakeholders' Adoption of Telerehabilitation Services: A Systematic Literature Review and Directions for Further Research. Arch Phys Med Rehabil 2021; 102:1390-1403. [PMID: 33484693 DOI: 10.1016/j.apmr.2020.12.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 12/12/2020] [Accepted: 12/26/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To examine the adoption of telerehabilitation services from the stakeholders' perspective and to investigate recent advances and future challenges. DATA SOURCES A systematic review of English articles indexed by PubMed, Thomson Institute of Scientific Information's Web of Science, and Elsevier's Scopus between 1998 and 2020. STUDY SELECTION The first author (N.N.) screened all titles and abstracts based on the eligibility criteria. Experimental and empirical articles such as randomized and nonrandomized controlled trials, pre-experimental studies, case studies, surveys, feasibility studies, qualitative descriptive studies, and cohort studies were all included in this review. DATA EXTRACTION The first, second, and fourth authors (N.N., W.I., B.N.) independently extracted data using data fields predefined by the third author (M.B.). The data extracted through this review included study objective, study design, purpose of telerehabilitation, telerehabilitation equipment, patient/sample, age, disease, data collection methods, theory/framework, and adoption themes. DATA SYNTHESIS A telerehabilitation adoption process model was proposed to highlight the significance of the readiness stage and to classify the primary studies. The articles were classified based on 6 adoption themes, namely users' perception, perspective, and experience; users' satisfaction; users' acceptance and adherence; TeleRehab usability; individual readiness; and users' motivation and awareness. RESULTS A total of 133 of 914 articles met the eligibility criteria. The majority of papers were randomized controlled trials (27%), followed by surveys (15%). Almost 49% of the papers examined the use of telerehabilitation technology in patients with nervous system problems, 23% examined physical disability disorders, 10% examined cardiovascular diseases, and 8% inspected pulmonary diseases. CONCLUSION Research on the adoption of telerehabilitation is still in its infancy and needs further attention from researchers working in health care, especially in resource-limited countries. Indeed, studies on the adoption of telerehabilitation are essential to minimize implementation failure, as these studies will help to inform health care personnel and clients about successful adoption strategies.
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Affiliation(s)
- Naghmeh Niknejad
- Institute of Research and Development, Duy Tan University, Da Nang, Vietnam; Faculty of Information Technology, Duy Tan University, Da Nang, Vietnam; School of Computing, Faculty of Engineering, Universiti Teknologi Malaysia, Johor Bahru, Malaysia
| | - Waidah Ismail
- Faculty of Science and Technology, Universiti Sains Islam Malaysia, Negeri Sembilan, Malaysia; Information System Study Program, Universitas Airlangga, Indonesia Kampus C, Mulyorejo, Surabaya, Indonesia.
| | - Mahadi Bahari
- Department of Information Systems, Azman Hashim International Business School, Universiti Teknologi Malaysia, Johor Bahru, Malaysia
| | - Behzad Nazari
- Department of Information Systems, Azman Hashim International Business School, Universiti Teknologi Malaysia, Johor Bahru, Malaysia
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