Mainstream Telerehabilitation: A Threat to the Physiotherapy Profession or a Paradigm-Shifting Opportunity?

Purpose: This study explored physiotherapists' attitudes toward telerehabilitation (TR) focusing on how TR adoption during COVID-19 impacted the physiotherapy (PT) profession and the sustained use of TR treatment models. Method: A survey mainly comprised of open-ended questions was administered to Canadian physiotherapists in private practice. The responses were analyzed with inductive content analysis to generate themes reflecting barriers and opportunities associated with TR. Results: Among barriers, the sub-themes of challenges with technology, technical know-how, patient buy-in, and professional identity emerged. Among opportunities, the sub-themes of patient empowerment and self-management, positive treatment outcomes, increased access, expanded skillset, and paradigm shifting emerged. A unique finding was the tension between the themes of TR threatening and narrowing physiotherapists' professional identities versus expanding PT practice with hands-off care models enabled by TR. Conclusions: This study corroborated past research showing technological and know-how barriers to TR adoption and suggested that TR has moved PT practice toward less reliance on passive therapies. An important implication of the study is that while TR may facilitate a paradigm shift toward patient self-management, buy-in may impede the sustainability of TR and other hands-off treatment models.