Telerehabilitation during the COVID-19 pandemic in Sweden: a survey of use and perceptions among physiotherapists treating people with neurological diseases or older adults

Abstract

Background Telerehabilitation, i.e. rehabilitation at a distance using Information and Communication Technology (ICT), is a promising avenue for improving health among people with neurological diseases or older adults who often experience limited access to services. Still, little is known about physiotherapists’ use, perceptions and needs with regards to telerehabilitation services. Aims To describe physiotherapists use and perceptions of, as well as needs for, telerehabilitation services for the rehabilitation of people with neurological diseases or older adults in Sweden. Methods In this cross-sectional study, an author-created survey was sent out to members of the Swedish Association of Physiotherapists including questions about the use and perceptions of existing telerehabilitation services (e.g. telephone, internet-based applications and mobile applications) as well as needs of future telerehabilitation services. The results were presented descriptively as numbers and percentages. Results Three hundred seven physiotherapists were included in this study with 139 (45%) treating people with neurological diseases and 168 (55%) treating older adults. Most respondents did not provide telerehabilitation before (74%) or during (51%) the COVID-19 pandemic. Telephone, which was predominantly used for administrative tasks, was the most frequent utilised ICT used by 68% of the physiotherapist using ICTs several days/week. Few respondents used internet-based applications (12%), mobile applications (3%) or SMS services (8%) and videoconferencing (3%). A majority of the respondents were interested in ICT (78%), felt comfortable using ICT (57%) and were interested in learning how ICT can be used in rehabilitation (92%). Still, few respondents perceived that people with neurological diseases or older adults can use existing ICTs for rehabilitation purposes (18%) and that existing reimbursement system within health care facilitates remote rehabilitation (16%). Important functionality of future ICT perceived by physiotherapists covered patient communication (e.g. chat, SMS and video), assessments (e.g. digital surveys and assessment of physical activity) and treatment (e.g. exercise prescription). Conclusion While physiotherapists had an overall positive perception to use and willingness to learn about telerehabilitation, few used telerehabilitation services before nor during the COVID-19 pandemic and they also perceived multilevel barriers for implementation, ranging from patients ability to use ICT to existing reimbursement systems within health care. Our findings emphasize the need to strengthen the expertise regarding remote services among physiotherapists.

Mobile health to promote physical activity in people post stroke or transient ischemic attack – study protocol for a feasibility randomised controlled trial

“…mobile phones, patient monitoring devices and applications) [ 25 ]; a promising avenue for providing equal and accessible health promotion services to people post stroke or TIA. Despite patients and healthcare professionals reporting high levels of acceptance towards mHealth both globally [ 26 ] and locally [ 27 ], implementation of mHealth services has been limited during the Covid-19 pandemic in Sweden [ 27 ]. mHealth can be beneficially adopted at various points during the patient-clinician therapeutic process from assessment, through to intervention, support, and follow-up [ 28 , 29 ].…”

Accessibility of social services and ICT‐based services for children with disabilities and their families

“…Various devices using ICT are being developed, but they are not widely used because of the lack of governance, including related laws, policies and national programs; awareness of children and their families; and services. In addition, equipment for service is expensive, and it is difficult to access the service environment physically and socially (Raja, 2016; experienced a long period of pandemic, the demand for ICT-based services for the disabled has increased (Alsem et al, 2020;, and many organizations are preparing for ICT-based services (Bezuidenhout et al, 2022;Park et al, 2021).…”

“…In addition, equipment for service is expensive, and it is difficult to access the service environment physically and socially (Raja, 2016; Ryan & Quinlan, 2018; WHO, 2015). However, as we have recently experienced a long period of pandemic, the demand for ICT‐based services for the disabled has increased (Alsem et al, 2020; Chadwick et al, 2022), and many organizations are preparing for ICT‐based services (Bezuidenhout et al, 2022; Park et al, 2021).…”

Patient experiences of remote care in a pain service during a pandemic

“… 31 A study of Swedish physiotherapists reported that most did not take up remote consultations readily, but felt there were potential significant benefits, for example,, use of the chat function, SMS messages, online surveys and sending treatment plans via the internet. 32 …”

“…31 A study of Swedish physiotherapists reported that most did not take up remote consultations readily, but felt there were potential significant benefits, for example,, use of the chat function, SMS messages, online surveys and sending treatment plans via the internet. 32 The use of EBD methods highlighted some important elements to delivering group-based pain education and rehabilitation. The importance of 'hope' as a concept in relation to PAINEDU was raised and maintained throughout the session.…”