Telerehabilitation Trends in Australian Physiotherapy and an Exploration of Factors That Influence Use After COVID-19 Restrictions: Qualitative Content Analysis

Background: Telerehabilitation is a safe and effective means of delivering physiotherapy services, but implementation in clinical practice has not been widespread. Objective: This study aimed to explore the shifts in telerehabilitation use throughout the COVID-19 pandemic and the key factors that influenced telerehabilitation caseload after restrictions were eased. Methods: Between September and November 2023, physiotherapists practicing in Australian private practice, hospital outpatient, or community settings completed an online survey. Data were collected regarding participants' use of telerehabilitation before, during, and after the COVID-19 pandemic restrictions to in-person physiotherapy. Qualitative content analysis of open-text questions was performed to garner more nuanced information about the use of telerehabilitation in clinical practice, and quantitative data were analyzed descriptively. Results: The proportion of participants using telerehabilitation rose from 30% (44/148) before the pandemic to 94% (138/147) when restrictions to in-person physiotherapy were in place. Although 82% (118/144) of the sample continued to deliver telerehabilitation after COVID-19 restrictions were eased, telerehabilitation accounted for only 14% of the total caseload. Exploratory analyses suggest that despite increased confidence, satisfaction, and perceptions about the effectiveness of telerehabilitation, reduced patient demand, physiotherapists' perceptions about patient preference for in-person consultations, and the perception that in-person physiotherapy is easier continue to influence the use of telerehabilitation in the post-COVID era. Conclusions: Despite increased uptake during the pandemic, telerehabilitation caseload after restrictions were eased was low. Physiotherapists' perceptions about telerehabilitation in clinical practice remain a substantial barrier to sustained adoption.