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.

Purpose: 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. Method: A cross-sectional design, web-based survey was disseminated to Ontario physiotherapists working in outpatient/community settings. Descriptive statistics were used for data analysis. Results: 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. Conclusions: 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.