Perceived Barriers and Facilitators of Using Synchronous Telerehabilitation of Physical and Occupational Therapy in Musculoskeletal Disorders: A Scoping Review

PurposePhysical and occupational therapy interventions are increasingly delivered through videoconferencing to overcome barriers related to face-to-face delivery. The objective of this scoping review was to identify barriers and facilitators of using synchronous telerehabilitation to deliver these interventions for musculoskeletal disorders.Materials and MethodsMEDLINE, EMBASE, PsycInfo, CINAHL, Cochrane Library, and ProQuest Dissertations and Theses databases were searched in May 2020. Qualitative and quantitative studies in any language that described barriers and facilitators of using synchronous videoconferencing for physical or occupational interventions or assessments for individuals with musculoskeletal diseases were eligible.ResultsTwenty-three publications were included that reported 59 facilitators and 41 barriers to using telerehabilitation. All included studies (100%) reported on facilitators, and 20 (87%) studies also reported on barriers. Most commonly reported facilitators included convenience and accessibility of services, audio and visual quality, and financial and time savings. Most commonly reported barriers included technological issues, privacy concerns, impersonal connection, and difficulty establishing rapport between patients and healthcare professionals.ConclusionsFactors including quality and user-friendliness may facilitate the delivery of physical or occupational therapy interventions or assessments for musculoskeletal diseases using telerehabilitation. Strategies to address key barriers should be considered when developing and implementing such interventions or assessments.Implications for rehabilitationVideoconferencing with a healthcare professional can be an effective way to deliver patient-centered physical or occupational therapy telerehabilitation interventions.Strategies to combat barriers to using telerehabilitation may include using a stable, high-quality videoconferencing platform, enhancing self-efficacy to using videoconferencing amongst patients and health care providers, and addressing concerns related to privacy.During the current COVID-19 pandemic, the present study provides insight into the successful development and delivery of physical or occupational telerehabilitation interventions for at-risk populations.