Feasibility of tele-rehabilitation in low resource setting: perceived barriers and facilitators among physiotherapy professionals

Abstract

Background: Robust evidence illustrates the significance and efficacy of telerehabilitation to optimize the participation in rehabilitation program taking into account organisational, geographical and transportation aspects. Despite knowing the remarkable benefits, there exist an array of challenges to implement telerehabilitation services in a setting with meagre resources. In order to augment the uptake of telerehabilitation services, our study aims to explore the perceived barriers and facilitators to telerehabilitation among Physiotherapy professional in a resource limited setting. Methods: A cross-sectional survey was conducted among physiotherapy professionals in Maharashtra using a questionnaire with a content validation index of 0.95. The survey sought to ascertain the awareness, barriers, facilitators and strategies to improve practice of telerehabilitation. Results: A total of 450 Physiotherapists were invited, of which, 201 participated in the study. The major barriers to telerehabilitation were inaccuracy in obtaining adequate information (n=149, 74%), lack of face-to-face monitoring (n=131, 65%) and physical limitation in older adults (n=114, 57%); on the other hand, the facilitators were reduced transportation time to hospital/clinic (n=132, 67%) and improved accessibility to healthcare services (n=125, 62%). The factors that enabled the patients to participate were flexible appointment schedule (n=139, 69%) and minimal transportation costs (n=129, 64%). Furthermore, the participants majorly considered encouraging patients’ appropriate environment, insurance coverage, training and upskilling of clinicians as the strategies to improve practice. Conclusions: The implementation of telerehabilitation program has been limited due to perceived constraints associated with various organizational, geographical and patient factors. However, physiotherapists reported strategies to improve practices could be implemented to accelerate the utilization of telerehabilitation services.