Reasons for Non-Adoption of Telerehabilitation Among Physiotherapists in Tunis, Tunisia
R Gharbi, G Kharroubi, E Arfaoui, I Cherif, W Affes, J BettaiebAbstract
Introduction
Telerehabilitation (TR) has emerged as an innovative modality to ensure continuity of care, particularly during the COVID-19 pandemic. Despite its potential benefits, its adoption by physiotherapists remains limited. This study aimed to identify the reasons for non-adoption of TR among Tunisian physiotherapists.
Methods
A cross-sectional study was conducted in March 2023 with a representative sample of physiotherapists in private practice in Greater Tunis, comprising the governorates of Tunis, Ben Arous, Ariana, and Manouba. Data were collected using a standardized face-to-face questionnaire. Data entry and analysis were performed using Epi Info software version 7.2.5.0.
Results
A total of 200 physiotherapists were included, 86.5% of whom were women. The median age was 32 years, ranging from 21 to 59. More than half of participants (59.0%) reported having already heard of TR. Among those (n = 118), nearly half (49.2%, 58/118) had used it in their practice. Physiotherapists who were aware of TR but had never adopted it (n = 60) were asked about their reasons for non-adoption. The main reason reported was the absence of physical contact with patients (65.0%), followed by no patient demand (25.0%) and lack of information about TR (20.0%). Other reasons included technical complexity (13.3%) and lack of infrastructure (6.7%).
Conclusions
Despite moderate awareness, telerehabilitation adoption remains limited among physiotherapists. Concerns about the lack of physical contact, along with informational, technical, and demand-related barriers, hinder its use. Addressing these factors is essential to support the integration of TR as a complementary modality in physiotherapy practice.
Key messages
• Despite awareness of telerehabilitation, 50.8% of informed Tunisian physiotherapists never adopted it, mainly citing the absence of physical patient contact (65%).
• Promoting TR adoption in Tunisia requires patient education on its benefits, stronger physiotherapist training, and adequate technical and logistical support.