Knowledge, Attitude, and Barriers to Telerehabilitation-Based Physical Therapy Practice in Saudi Arabia

Abstract

(1) Telerehabilitation (TR) is a part of telemedicine involved in providing rehabilitation services to people in remote locations. TR in physical therapy in the kingdom of Saudi Arabia is still in its infancy and its implementation may pose different challenges in the physical therapy settings. The purpose of this nation-wide survey is to explore physiotherapists (PTs) knowledge, attitudes, and barriers towards implementation of TR in physical therapy settings; (2) Methods: A 14 item questionnaire was developed and mailed to PTs working in hospitals and rehabilitation centers across 13 provinces in Saudi Arabia; (3) Results: 347 PTs responded. Results are as follows: 58.8% (n = 204) of PTs reported that they had sufficient knowledge about TR. About31.7% (n = 110) of PTs reported that their hospital and rehabilitation center had installed TR, yet only 19.9% (n = 69) utilized the TR facility. Image-based TR was more frequently used (n = 33) as compared to sensor-based TR (n = 29) and virtual reality TR (n = 10).The main barriers were technical issues and cost related to implement TR in physical therapy settings; and (4) Conclusions: There is a relatively high number of PTs with self-reported knowledge about TR, however facilities and usage were limited. The main barriers were technical issues, staff skills, and the high cost involved in the introduction of TR in the PT-based health care settings.

"We are so close; yet too far": perceived barriers to smartphone-based telerehabilitation among healthcare providers and patients with Chronic Obstructive Pulmonary Disease in India

“…We observed that while PR providers have a reasonable to good level of understanding, their practice is limited due to organizational and economic factors. Our study findings corroborate a recent Saudi Arabian survey about the lack of telehealth-based physical therapy practices, though the study showed increased telemedicine knowledge among physiotherapy experts ( Aloyuni et al., 2020 ). Similarly, patients responding to our survey expressed a high level of interest in telerehabilitation services but expressed concern about the availability and expertise of telehealth-based PR treatments.…”

Physiotherapists’ perceptions of and willingness to use telerehabilitation in Kuwait during the COVID-19 pandemic

“…This finding is consistent with previous studies wherein PTs reported that limited access to technical support at their facilities was behind them not adopting telerehabilitation [ 10 , 14 ]. In contrast, PTs in Saudi Arabia reported lower utilization of telerehabilitation services by patients during the COVID-19 pandemic, despite the availability of technical support [ 27 ]. In the present study, the interview results reveal that the managers of the physiotherapy departments comprehended the need for telerehabilitation services during the pandemic, so some of their departments had started offering telerehabilitation services in order to prevent the spread of COVID-19, as well as to reduce waiting lists, facilitate patients’ access, and decrease patients’ transport time to attend clinics.…”

“…A lack of suitable training in the use of equipment to practise telerehabilitation was another barrier that was highlighted by most of the PTs, as technology barriers are considered a major issue in implementing telehealth systems [ 28 ]. In Saudi Arabia, PTs reported a lack of technical and staff skills as the main barriers to telerehabilitation [ 27 ]. The physiotherapy managers confirmed these barriers, as well as the disadvantages of telerehabilitation, which include a lack of hands-on skills, difficulty in practising real physiotherapy via video-calls, and the inability to create the same level of trust between specialists and patients.…”

“…Similarly, previous studies have shown that technically challenged staff are a major barrier to the adoption of telehealth [ 29 – 31 ]. A systematic review indicated that the strongest barriers are technology related but can be overcome through training [ 27 ]. Therefore, training programmes may help in overcoming technology-related barriers, and this concept was also emphasized by the managers regarding the need for awareness-raising initiatives to improve the telerehabilitation practices among PTs during and after the COVID-19 pandemic.…”

Barriers and Challenges of Implementing Telerehabilitation: A Systematic Review

“…Other barriers were technical issues, the lack of information, the lack of involvement in planning, the shortage of exposure to e-healthcare information, resistance to change, the lack of using hardware and software, low connectivity, staff skill problems, and high-cost provider's willingness, and the location of the healthcare institute. In addition to these limitations, the attitudes of policymakers impact the use of TR services [13,16]. [14].…”