Telerehabilitation Delivery in Canada and the Netherlands: Results of a Survey Study

Edward Giesbrecht; Mel E Major; Moni Fricke; Pamela Wener; Maarten van Egmond; Jesse J Aarden; Cara L Brown; Margriet Pol; Marike van der Schaaf

doi:10.2196/45448

Telerehabilitation Delivery in Canada and the Netherlands: Results of a Survey Study

JMIR Rehabil Assist Technol. 2023 Feb 20:10:e45448. doi: 10.2196/45448.

Authors

Edward Giesbrecht¹, Mel E Major^{2

3

4}, Moni Fricke⁵, Pamela Wener¹, Maarten van Egmond^{2

3

4

6}, Jesse J Aarden^{2

3

4

6}, Cara L Brown¹, Margriet Pol^{3

7

8}, Marike van der Schaaf^{3

4

9}

Affiliations

¹ Department of Occupational Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB, Canada.
² Department of Physical Therapy, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands.
³ Research Group Occupational Therapy: Participation and Environment, Center of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands.
⁴ Amsterdam Movement Sciences, Ageing and Vitality, Amsterdam, the Netherlands.
⁵ Department of Physical Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB, Canada.
⁶ European School of Physiotherapy, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands.
⁷ Department of Medicine for Older People, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
⁸ Amsterdam Public Health, Aging & Later Life, Amsterdam, the Netherlands.
⁹ Rehabilitation Medicine, Meibergdreef 9, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands.

PMID: 36806194
PMCID: PMC9989917
DOI: 10.2196/45448

Abstract

Background: Following the onset of the COVID-19 pandemic, telerehabilitation (TR) has been expanding to address the challenges and risks of in-person delivery. It is likely that a level of TR delivery will continue after the pandemic because of its advantages, such as reducing geographical barriers to service. Many pandemic-related TR initiatives were put in place quickly. Therefore, we have little understanding of current TR delivery, barriers and facilitators, and how therapists anticipate integrating TR into current practice. Knowing this information will allow the incorporation of competencies specifically related to the use and provision of TR into professional profiles and entry-to-practice education, thereby promoting high-quality TR care.

Objective: This study aimed to obtain a descriptive overview of current TR practice among rehabilitation therapists in Canada and the Netherlands and identify perceived barriers to and facilitators of practice.

Methods: A web-based cross-sectional survey was conducted with occupational, physical, and respiratory therapists and dietitians in Canada (in French and English) and the Netherlands (in Dutch and English) between November 2021 and March 2022. Recruitment was conducted through advertisements on social media platforms and email invitations facilitated by regulatory and professional bodies. The survey included demographic and practice setting information; whether respondents delivered TR, and if so, components of delivery; confidence and satisfaction ratings with delivery; and barriers to and facilitators of use. TR satisfaction and uptake were measured using the Telehealth Usability Questionnaire and modified Technology Acceptance Model. Data were first summarized descriptively, and then, comparisons were conducted between professions.

Results: Overall, 723 survey responses were received, mostly from Canada (n=666, 92.1%) and occupational therapists (n=434, 60%). Only 28.1% (203/723) reported receiving specific training in TR, with 1.2% (9/723) indicating that it was part of their professional education. Approximately 19.5% (139/712) reported not using TR at all, whereas most participants (366/712, 51.4%) had been using this approach for 1 to 2 years. Services delivered were primarily teleconsultation and teletreatment with individuals. Respondents offering TR were moderately satisfied with their service delivery and found it to be effective; 90.1% (498/553) indicated that they were likely to continue offering TR after the pandemic. Technology access, confidence, and setup were rated the highest as facilitators, whereas technology issues and the clinical need for physical contact were the most common barriers.

Conclusions: Professional practice and experience with TR were similar in both countries, suggesting the potential for common strategic approaches. The high prevalence of current practice and strong indicators of TR uptake suggest that therapists are likely to continue TR delivery after the pandemic; however, most therapists (461/712, 64.7%) felt ill prepared for practice, and the need to target TR competencies during professional and postprofessional education is critical. Future studies should explore best practice for preparatory and continuing education.

Keywords: capabilities; competencies; digital health; eHealth; mobile phone; telehealth; telerehabilitation.

©Edward Giesbrecht, Mel E Major, Moni Fricke, Pamela Wener, Maarten van Egmond, Jesse J Aarden, Cara L Brown, Margriet Pol, Marike van der Schaaf. Originally published in JMIR Rehabilitation and Assistive Technology (https://rehab.jmir.org), 20.02.2023.