Telerehabilitation Services Research Articles

A service evaluation of patients and clinicians experience of video consultations in a specialist outpatient neuro-rehabilitation service

IntroductionThere has been a rapid adoption of telerehabilitation services, particularly during the COVID-19 pandemic, with minimal guidance or evaluation of benefit. This survey explores experiences of video consultations in a specialist outpatient neuro-rehabilitation service. MethodsDigital surveys were designed to evaluate experience of Attend Anywhere. Anyone could answer the survey after attending a video consultation. Setting and participantsPatients and Doctors, occupational therapists, physiotherapists and speech and language therapists from a specialist outpatient neuro-rehabilitation service, between January and November 2020. ResultsA total of 637 surveys were analysed. 74.6% clinicians and 46.4% patients indicated video consultations were effective (X2=158.6, p<0.001). Physiotherapists indicated video consultation was not as effective as face to face (30.6%, X2=12.5, p=0.052). Over 95% of clinicians and patients reported they would use the video consultation system again X2=5.8, p<0.016. ConclusionsVideo consultation offers potential for improving access to healthcare for patients with complex neurological conditions.

Telerehabilitation Guidelines for Patients with Breast Cancer

This article provides a comprehensive analysis of the current developments in telerehabilitation, focusing on the regulatory and legal frameworks for delivering telerehabilitation services, the clinical manifestations of postmastectomy pain syndrome, and the role and significance of the International Classification of Functioning, Disability, and Health (ICF) in the telerehabilitation of patients with breast cancer (BC). The document also explores telerehabilitation interventions for BC. A detailed description of the software and hardware tools is provided, including the structural and functional overview of the Telerehabilitation Platform (TRP), software modules such as "Telerehabilitation," "Medical Reports," the Administrative Subsystem, the Information-Analytical Subsystem, which encompass the PM&amp;R physician’s digital workspace, the PM&amp;R Expert Subsystem, and the Patient’s digital workspace. It also covers existing and prospective scales for evaluating the effectiveness of telerehabilitation, as well as the specifics of working with identified patients in accordance with the eHealth (Electronic Healthcare System of Ukraine) requirements. The guidelines conclude with organizational and methodological aspects for implementing telerehabilitation programs, including initial and stage-specific rehabilitation assessments, basic ICF sets, and various patient-specific telerehabilitation programs. These include a patient-centered program for the preoperative stage of telerehabilitation and individualized programs for the post-acute and long-term phases. The eight appendices include questionnaires, physical therapy programs, protocols, diaries, and requirements for the equipment and staff of the telerehabilitation/telemedicine office, among other resources.

Feasibility of telerehabilitation to address the orientation and mobility needs of individuals with visual impairment: perspectives of current guide dog users

Orientation and Mobility (O&M) training, including guide dog services, is crucial for individuals with low vision and blindness to attain independent travel. While teleassistance has proven effective for navigation and communication, telerehabilitation in O&M remains unexplored. Objective To assess guide dog users’ perspectives on the feasibility of telerehabilitation for their O&M needs. Method An online survey gathered insights from 56 guide dog (GD) users (Mean age = 59, Mean GD used = 4, Mean duration of use = 22 years). Thirteen GD users further participated in interviews or focus groups to explore survey responses. Data were analyzed using content analysis. Findings Most (40) were blind, and 16 had low vision, with intermediate (25) and advanced (25) communication technology proficiency. Most GD users (46) underwent residential training, and 10 received one-on-one visits. Qualitative analysis revealed acceptance of telerehabilitation services, citing accessibility as an advantage. However, GD users expressed concerns about safety, potential loss of behavioral observation, and social contact loss. Success depended on the type of technology, service type, and personal attributes. Conclusion While feasible, telerehabilitation services may not be universally suitable for all training stages. Flexibility and applicability in service design are necessary to accommodate individual preferences and experience levels.

Access, Readiness and Willingness to Engage in Allied Health Telerehabilitation Services for Adults: Does Cultural and Linguistic Diversity Make a Difference?

Telerehabilitation is an appealing service delivery option for optimising recovery. Internationally, the equity of telerehabilitation services for people from culturally and linguistically diverse (CALD) backgrounds has been questioned. Using a 31-item survey, our study explored the access, readiness and willingness of 260 patients receiving allied health services from a large tertiary health service located in Sydney, Australia, to use telerehabilitation for adults. Overall, 72% patients reported having access to technology, 38% met our readiness criteria and 53% reported willingness to engage in telerehabilitation. There were no differences in access, readiness and willingness to engage in telerehabilitation between patients from CALD and non-CALD backgrounds. Age was the only factor that influenced access (OR = 0.94, 95% CI 0.90 to 0.97), readiness (OR = 0.95, 95% CI 0.92 to 0.98) and willingness (OR = 0.97, 95% CI 0.95 to 1.00) to engage in telerehabilitation. Past experience of telerehabilitation was related to willingness (OR = 2.73, 95% CI 1.55-4.79) but not access (OR = 1.79, 95% CI 0.87 to 3.68) or readiness (OR = 1.90, 95% CI 0.93 to 3.87). Our findings highlight the importance of ensuring positive patient experiences to promote ongoing willingness to use telerehabilitation. Efforts are needed to improve patients' digital health literacy, especially patients from older age groups, to ensure equitable engagement in telerehabilitation services.

Telerehabilitation Services for Communication Disorders during Covid-19 in a Tertiary Care Set-up: a Descriptive Report

Speech and language therapy (SLT) services were suspended for a major part in the year 2020 due to COVID- 19 spread. Reinstating SLT services via alternate medium of Telerehabilitation (TR) was imperative to provide continued care for various disorders along with providing a support base for the caretakers during these difficult times. This paper presents a descriptive report of SLT services provided via TR in a tertiary care hospital for months of January till October 2021.

Teleassistance Telerehabilitation Services for urgent mental health needs of people with Intellectual and Developmental disabilities

Abstract Persons with intellectual disability (PwID) and/or and autism spectrum disorder with high support needs (ASD-HSN) have resulted to be among the most vulnerable populations to COVID-19 and distress factors associated to the measures for containing its spread. Many health, rehabilitation, and assistance needs were managed through the use of telemedicine, specifically teleassistance (TA) and telerehabilitation (TR), with regard to the prevention and treatment of the epidemic illness as well as the continuity of care required for the condition of developmental disability and co-occurring physical or mental disorders. TA and TR can function either directly or indirectly with the PwID/ASD; in the latter case, a family member, a regular caregiver, or a technician provides local mediation. This paper examines the most common TA and TR activities, along with their requirements, applications, and goals. All of these activities should be in line with the overarching goal of each customized therapy and rehabilitation plan, which is to enhance and support the quality of life for people with intellectual and developmental disabilities. Studies on TA and TR efficacy for PwID/ASD are limited, especially concerning adulthood. The scant research that is currently available demonstrates efficacy in maintaining or marginally enhancing cognitive, adaptive, and vocational skills. In addition to managing both routine and unusual activities as well as critical episodes, family members and other caregivers reported feeling more empowered about their educational and interpersonal abilities with the PwID/ASD. The primary benefits over traditional in-person services have been found to be greater accessibility and availability as well as a reduction in both physical and psychological distance. The primary limits include the absence of all elements of the therapeutic alliance pertaining to face-to-face communication, possible poor ability to use technology, accessibility of the technology itself, concerns regarding privacy, and variables that divert attention connected to the household setting. Even while telemedicine has proven to be feasible and beneficial thus far, it is doubtful that traditional techniques will be able to be replaced, at least not anytime soon. Telemedicine could, nonetheless, serve as a useful addition, integration, or short-term substitute. Future studies should provide light on the indications, contextual deployment, efficacy evaluation, and operational stability over time of certain TA and TR activities in addition to the use of artificial intelligence, machine learning, and interactive avatars.Disclosure of InterestNone Declared

COVID-19 pandemic: maker or breaker for families having children with autism spectrum disorder-case series of maternal experiences, strategies and suggestions

The COVID-19 pandemic due to prioritization of emergency and COVID-19 patient care at hospitals and disruption of daily routines and finances, impacted significantly families having people with special needs. This case series highlights the problems faced and strategies used by mothers of children having autism spectrum disorder (ASD). It summarizes the experiences of nine families of ASD children (2 to 9 years), selected consecutively from pediatric developmental/disability outpatient department (OPD) of a tertiary care center during i.e. April 2021 to May 2021 (2nd wave of COVID-19 pandemic) using a pre-designed proforma. Socio-demographic details, maternal experiences about challenges faced in child’s home care, special therapies, managing child’s behaviour, family support system, adaptations and their suggestions were recorded. The age group was 2 to 9 years and 8 were males. 7 out of 9 mothers reported that their child’s interaction with father and other family members improved. Institutional therapy was discontinued by all mothers. Two mothers reported increased aggression in the child. Mothers from joint family and having supportive families reported less stress. Children who had company of parents/grandparents/sibling and availability of indoor games, art and craft and storytelling, reported less screen time and less behavioural disturbances though all the mothers reported increased screen time compared to pre COVID times. Mother’s empowerment is key to success. Indoor physical games, unstructured play, increasing social awareness, supportive families, tele-rehabilitation services can improve overall progress in ASD children. Health care practices need to be revised from time to time for special needs/situations.

Characterization of Telerehabilitation Visits and Patient Satisfaction in Outpatient Physical Medicine and Rehabilitation Clinics From March 2020 to November 2021.

The aim of the study is to explore the usability of and satisfaction with telerehabilitation services provided to rehabilitation patients with various diagnoses at two large urban medical facilities during the COVID-19 pandemic. This was a usability study and all patients that received telerehabilitation services from March 2020 to November 2021 were included. Of the 4070 surveys sent via mail or email links to REDCap, 405 were completed (10% response rate). Participants completed demographic surveys, surveys on the telerehabilitation visit characteristics, telerehabilitation usability, and overall satisfaction with the visit. Patients were mostly women (64.4%), White, non-Hispanic (74.3%), and English-speaking (99%). Most patients were seen via telerehabilitation due to COVID-19 restrictions (37.1%). Patients were generally satisfied with their telerehabilitation visit (3.64 out of 4). Additionally, patients generally found telerehab to be useful (6.4 out of 7), easy to use (6.3 out of 7), effective (6.2 out of 7), satisfactory (6.3 out of 7), and comparable to in-person visits (6.5 out of 7). Patients generally reported feeling satisfied and comfortable with telerehabilitation visits and felt that they were comparable to in-person visits. Future research should examine the impact of socioeconomic factors on telerehabilitation use, with a focus on education level and non-English speakers.

Barriers and facilitators for increased accessibility to quality rehabilitation services in low- and middle- income countries: a systematic review.

With an increasing number of people experiencing limitations in functioning during their life course, the need for comprehensive rehabilitation services is high. In 2017, the WHO Rehabilitation 2030 initiative noted that the need for the establishment and expansion of rehabilitation services is paramount in order to obtain well-being for the population and to ensure equal access to quality healthcare for all. The organization of rehabilitation services is however facing challenges especially in low-and middle-income countries with a very small proportion of people who require rehabilitation actually getting them. Various surveys conducted in low-and -middle income countries have revealed existing gaps between the need for rehabilitation services and the actual receipt of these services. This systematic review aimed to determine the barriers and facilitators for increasing accessibility to rehabilitation services in low- and middle-income countries. Recommendations for strengthening rehabilitation service organization are presented based on the available retrieved data. In this systematic review, an electronic search through three primary databases, including Medline (PubMed), Scopus and Web of Science (WOS) was conducted to identify original studies reporting on barriers and facilitators for rehabilitation service organization in low-and middle-income countries. Date of search: 25th April 2021 (PubMed), 3rd May 2021 (Scopus and Web of Science). All studies including barriers or/and facilitators for rehabilitation services in low- and middle income countries which were written in English were included in the review. The articles written in other languages and grey literature, were excluded from this review. Total of 42 articles were included from year 1989 to 2021. Numerous barriers were identified that related to education, resources, leadership, policy, technology and advanced treatment, community-based rehabilitation (CBR), social support, cultural influences, political issues, registries and standards of care. National health insurance including rehabilitation and funding from government and NGOs are some of the facilitators to strengthen rehabilitation service organization. Availability of CBR programs, academic rehabilitation training programs for allied health professionals, collaboration between Ministry of Heath (MOH) and Non-governmental Organizations (NGOs) on telerehabilitation services are amongst other facilitators. Recommendations for improving and expanding rehabilitation service organization include funding, training, education, and sharing of resources.

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

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.

NURSING TELECONSULTATION FOR PEOPLE WITH SPINAL CORD INJURY: NURSES’ OPINION ON THE MAIN GUIDELINES

Objective: to identify the opinion of nurses on the main topics to be addressed in the nursing teleconsultation of a telerehabilitation program for spinal cord injuries. Methods: descriptive and exploratory study, carried out with experienced nurses in the rehabilitation of people with spinal cord injuries in a network of rehabilitation hospitals. 70 nurses participated in the study. The data were collected through self-administered questionnaires built on the Google Forms® platform and organized in an Excel® spreadsheet. A descriptive statistical analysis of objective responses and a categorical content analysis of discursive responses were performed. Results: Nurses considered it important to accompany people with spinal cord injuries in the transition from care to home and to provide guidance through social networks, telephones, and/or applications. It was found that the main topics to be addressed in the nursing teleconsultation in a telerehabilitation service are skin care and bladder and bowel reeducation. Conclusions: The nursing teleconsultation allows the exchange of information between the nurse of a specialized rehabilitation service and the person with a spinal cord injury in their home environment, encouraging learning and enabling the person’s co-participation and proactivity in managing their self-care.

Opinions, satisfaction and expectations of individuals with multiple sclerosis about telerehabilitation services

ObjectiveThe opinions, satisfaction, and expectations of telemedicine can provide essential data for remote health services in individuals with Multiple Sclerosis (MS). The study aimed to demonstrate the views (barriers-benefits), satisfaction, and expectations of individuals with MS about telerehabilitation services. MethodsA prospective cross-sectional was conducted with 82 individuals with MS who received telerehabilitation services for at least one year. The participants have completed SymptoMScreen, Beck Depression Inventory (BDI), Telehealth Usability Questionnaire (TUQ), Telemedicine Satisfaction Questionnaire (TSQ), Telehealth Barriers Questionnaire (TBaQ and Telehealth Benefits Questionnaire (TBeQ). ResultsAs the age of individuals with MS increased, TUQ (r: −0.517, p < 0.001) and TBeQ (r: −0.383, p < 0.001) decreased, while TSQ (r: 0.405, p < 0.001) and TBaQ (r: 0.390, p < 0.001) increased. SymptoMScreen score (r: −0.288, p < 0.05) was weakly associated with TUQ. In addition, TUQ, TSQ, TBeQ, and TBaQ were strongly correlated (p < 0.001). ConclusionIn order to improve usability and satisfaction in telerehabilitation services, the age, symptom severity, and education levels of individuals with MS should be considered. Telehealth methods with high usability should be preferred to increase patient satisfaction.

Exploring the Awareness, Perception, Acceptability and Confidence Level Towards Telerehabilitation among Stroke Patients’ Caregivers in the Federal Territory of Malaysia

Telerehabilitation is the ability to provide distance support, evaluation and intervention to individuals who are undergoing rehabilitation therapy through telecommunication. This study aimed to explore the awareness, acceptability and confidence level towards telerehabilitation among caregivers of cerebral stroke patients in the federal territory of Malaysia. A cross-sectional study was conducted amongst stroke patients’ caregivers from general hospitals in the federal territory of Malaysia. Descriptive statistics were used to analyse the awareness, acceptability and confidence level towards telerehabilitation technology among stroke patients’ caregivers. The correlation between confidence level in using technology devices and their acceptance level of telerehabilitation was assessed by using Spearman correlation analysis. Results showed that 70% of caregivers were aware of the telerehabilitation technology, amongst which 60.5% were willing to use the technology for rehabilitation purposes. Out of all the types of devices, 50% of caregivers demonstrated a high confidence level in using smartphones. However, only 25.7% demonstrated a high confidence level in using video call services for telerehabilitation service. In conclusion, the majority of caregivers in the federal territory of Malaysia demonstrated a positive attitude towards telerehabilitation services for stroke patients.

Evaluating Effectiveness of Telerehabilitation Services Among Injured Workers Treated in a Canadian Workers' Compensation System: A Population-Based Study.

To evaluate the effectiveness of telerehabilitation for promoting return-to-work (RTW) among injured workers. We conducted a pragmatic, quasi-experimental study comparing telerehabilitation, in-person, or hybrid services. Descriptive statistics analyzed demographics, occupational factors, and patient-reported outcome measures (PROMs). Kruskal-Wallis tests investigated differences between mode of delivery and changes in PROM scores. Logistic and Cox-proportional hazard regression examined associations between mode of delivery and RTW status or days receiving wage replacement benefits in the first-year post-discharge, respectively, while controlling for potential confounders. A slightly higher percentage of the 3,708 worker sample were male (52.8%). Mean (standard deviation (SD)) age across all delivery formats was 45.5 (12.5) years. Edmonton zone had the highest amount of telerehabilitation delivery (53.5%). The majority of workers had their program delivered in a hybrid format (54.1%) and returned to work (74.4%) at discharge. All PROMs showed improvement although differences across delivery formats were not clinically meaningful. Delivery via telerehabilitation had significantly lower odds of RTW at discharge (Odds Ratio: 0.82, 95% Confidence Interval: 0.70-0.97) and a significantly lower risk of experiencing suspension of wage replacement benefits in the first year following discharge (Hazard Ratio: 0.92, 95% Confidence Interval: 0.84-0.99). Associations were no longer significant when confounders were controlled for. RTW outcomes were not statistically different across delivery formats, suggesting that telerehabilitation is a novel strategy that may improve equitable access and earlier engagement in occupational rehabilitation. Factors such as gender and geographic location should be considered when deciding on service delivery format.

Investigating the Effects of Telerehabilitation on Improving the Physical Activity of Individuals with Multiple Sclerosis: A Systematic Review of Randomized Controlled Trial

Introduction: This study systematically evaluates the effect of telerehabilitation on improving physical activity, physical function, and quality of life (QoL) in individuals with multiple sclerosis (MS).&#x0D; Materials and Methods: Studies were obtained by searching the title, abstract, and keywords without time limit in the Scopus, PubMed, Embase, and Web of Science databases. The quality of the included studies was assessed using the Joanna Briggs institute checklist. The same checklist was used for data extraction.&#x0D; Results: A total of 16 eligible articles were found. In 12 studies, the results showed significant performance improvement, reduced fatigue, improved physical activity, and general balance in the telerehabilitation approach. Furthermore, of the 16 included studies, 5(31) reported an improvement in individuals’ QoL, two of which showed a significant improvement in the individuals’ QoL in the intervention group compared to the control group.&#x0D; Conclusion: The findings of this review showed that telerehabilitation services for MS individuals’ precautions are comparable to or better than conventional services. Telerehabilitation is an effective educational instrument to restitute and maintain physical activity and balance in individuals with MS; however, no considerable improvement in individuals’ QoL was reported.

Personalized robots for long-term telerehabilitation after stroke: a perspective on technological readiness and clinical translation.

Stroke rehabilitation, which demands consistent, intensive, and adaptable intervention in the long term, faced significant challenges due to the COVID-19 pandemic. During this time, telerehabilitation emerged as a noteworthy complement to traditional rehabilitation services, offering the convenience of at-home care delivery and overcoming geographical and resource limitations. Self-help rehabilitation robots deliver repetitive and intensive physical assistance, thereby alleviating the labor burden. However, robots have rarely demonstrated long-term readiness for poststroke telerehabilitation services. The transition from research trials to general clinical services presents several challenges that may undermine the rehabilitative gains observed in these studies. This perspective discusses the technological readiness of personal use robots in the context of telerehabilitation and identifies the potential challenges for their clinical translation. The goal is to leverage technology to seamlessly integrate it into standard clinical workflows, ultimately enhancing the outcomes of stroke rehabilitation.

Usability of a telerehabilitation program for patients with musculoskeletal or oncological diseases: A mixed-methods evaluation / Benutzerfreundlichkeit eines Telerehabilitations-Programmes für Patient*innen mit muskuloskelettalen oder onkologischen Erkrankungen: Eine Mixed-Methods Evaluation

Abstract Purpose Telerehabilitation may stabilize the results of a previous phase 2 rehabilitation program through remote rehabilitation sessions. We evaluated a new telerehabilitation service (PV RehaTRAIN®) during its initial implementation, focusing on its usability both from the perspective of patients with musculoskeletal or oncological diseases and the interdisciplinary treatment team. Methods The evaluation followed a convergent mixed-methods design. After separate qualitative and quantitative analyses of the multi-perspective findings from interviews, focus groups and questionnaires, we interpreted the results collectively and equally. Results Overall, the results indicate high acceptance of and satisfaction with the new telerehabilitation service, especially from the patients’ perspective and regarding educational and individual counselling sessions. However, the treatment team identified a need for further didactic training to enable them to realize their full professional potential in a telerehabilitation setting. Conclusion The new telerehabilitation service PV RehaTRAIN® may bridge gaps in health care for patients who do not have access to conventional phase 3 rehabilitation infrastructure or prefer remote services that are readily integrated into their everyday lives. Members of the interdisciplinary treatment team offering telerehabilitation for the first time need adequate technical and especially setting-specific didactic training. Increased participation of treatment teams when refining telerehabilitation systems may minimize problems in early implementation phases and contribute to the quality of care.

Interest in Telerehabilitation Among Patients with Mild to Severe Multiple Sclerosis: Results of the Czech Republic.

Background: Research in telerehabilitation (TR) in neurology tends to focus on patients with low to moderate disability. For neurology patients with severe mobility limitations, TR can help to enable rehabilitation for people whose mobility limitations make it difficult for them to access rehabilitation facilities. The aim of this study is to evaluate the interest of people with neurological disability caused by multiple sclerosis (MS) in TR services. Methods: This electronic survey targeted individuals with MS, specifically those with a higher level of disability. Results: A total of 355 patients with MS (155 with severe disabilities) participated in this study. There was no difference in interest in rehabilitation between people with mild-to-moderate and severe disabilities (p = 0.1258, confidence interval [CI] = 95%). However, we found a higher interest in upper limb exercises (p = 0.0006, CI = 95%) and balance training (p = 0.0000, CI = 95%) among people with higher disability. Conclusion: The results of this study may help to improve the planning and targeting of TR interventions, where a different focus of intervention is appropriate for patients with different levels of disability. This may enable TR to be maximally tailored to patient capabilities and current greatest limitations. For example, for people with severe disabilities, it is appropriate to focus on training the upper limb function to maintain self-sufficiency and implement interventions to prevent falls.

A rapid review protocol of physiotherapy and occupational therapy telerehabilitation to inform ethical and equity concerns.

Telerehabilitation (TR) has emerged as a feasible and promising approach for delivering rehabilitation services remotely, utilizing technology to bridge the gap between healthcare providers and patients. As new modalities of virtual care and health technologies continue to emerge, it is crucial to stay informed about the growing landscape of virtual care to ensure that telehealth service delivery is ethical and equitable, and improves the quality of services and patient outcomes. The primary objective of this article is to present the protocol of a rapid review to examine the equity-related aspects surrounding the implementation of TR. This includes a comprehensive analysis of the ethical dimensions and fairness concerns linked to this practice. A rapid review protocol was developed in accordance with Cochrane Rapid Reviews Methods Guidance. Medline and EMBASE databases were searched between January 2010 and March 2023. Study selection and data extraction will be conducted in two phases (Phase I) by two independent reviewers and subsequently (Phase II) by a single reviewer. Our study will utilize the PROGRESS-Plus and Equitable virtual rehabilitation in the metaverse era framework to identify dimensions where potential inequities may exist within TR interventions. This rapid review is anticipated to enhance our knowledge of TR in the fields of physiotherapy and occupational therapy, with a specific focus on its influence on ethical and equitable practices and providing a foundation for informed decision-making and improved patient care. This rapid review will contribute to the advancement of our understanding of TR within physiotherapy and occupational therapy. Through synthesizing existing evidence, this study not only addresses current gaps in knowledge but also offers valuable insights for future research and clinical practice in TR services.

Exploring physiotherapists' perceptions of telerehabilitation for musculoskeletal disorders: Insights from focus groups.

This study explored the perceived benefits, barriers, and recommendations of telerehabilitation for musculoskeletal disorders among physiotherapists in Malaysia. This study employed an exploratory qualitative methodology to gather the perceptions of government-employed physiotherapists in Malaysia regarding the benefits, barriers, and recommendations for telerehabilitation in treating musculoskeletal disorders. The researchers conducted semistructured focus group discussions (FGDs) via Google Meet, which were recorded, transcribed, and analyzed using thematic analysis. Five FGDs were conducted with 24 participants, 37.5% of whom had prior experience with telerehabilitation. The data analysis returned three main themes: (1) perceived benefits, (2) barriers, and (3) recommendations. Four subthemes were derived from perceived benefits: (1a) saving time and money, (1b) convenience, (1c) clients responsible for their treatment, and (1d) alternatives for infectious diseases. Perceived barriers revealed three subthemes: (2a) technology, (2b) organization, and (2c) personal barriers. Finally, participants provided recommendations for improving telerehabilitation services, including training programs to facilitate greater acceptance of this modality. The findings of this study offer crucial insights into the evolving landscape of telerehabilitation in Malaysia. These findings revealed a greater prevalence of barriers to enablers among Malaysian physiotherapists, potentially influenced by varying experience levels. Despite the prevailing lack of experience among participants, this research underscores the significance of identifying barriers and enablers in implementing telerehabilitation with participants offering recommendations for integrating telerehabilitation into their practices. This study provides clear insights and a roadmap for stakeholders aiming to shape the future of telerehabilitation among physiotherapists in Malaysia.