DOI: 10.6084/m9.figshare.30788107.v1
title: Use of telerehabilitation by clinicians: barriers and levers to its adoption in clinics

description: The aim of this study was to identify the factors that might influence clinician adoption of telerehabilitation for post orthopaedic surgery knee and hip patients. Semi-structured interviews were conducted with 17 clinicians (doctors, physiotherapists, teachers of adapted physical activity). These interviews were guided by an interview framework inspired by Unified theory of acceptance and use of technology 2 (UTAUT2). The System Usability Scale (SUS) was used to assess clinicians’ perception of usability. The interviews highlighted the facilitators perceived by the clinicians, such as the extension of the benefits of physical activity, the personalised follow-up of patients (<i>via</i> gamification), the complementarity to conventional therapy, and the cost. The results also highlighted perceived barriers, including the fact of using only telerehabilitation and the risk of injury. SUS results were not influenced by the subject’ gender, age, or experience. The average SUS score of clinicians was 74 ± 13.2, which represents good acceptance of the device. A key factor for adherence is a user-centered design. Individualised programs based on gamification would benefit users by promoting a participative approach between clinicians and patients, fostering autonomy. Clinicians should set achievable goals, with clinicians motivating patients to stay engaged in physical activity, ensuring long-term benefits. Telerehabilitation will undoubtedly become a crucial part of future rehabilitation care. Telerehabilitation adoption by clinicians is strongly influenced by organisational support, including access to appropriate technology and dedicated time for remote clinical activities.Addressing clinicians’ digital competencies through targeted training can significantly reduce resistance and increase confidence in delivering rehabilitation services via telehealth platforms.Clear clinical guidelines and institutional policies are essential to support consistent and safe use of telerehabilitation in routine practice.Care models combining in-person and remote interventions can improve access to care while maintaining clinical quality, particularly for patients with mobility limitations or living in remote areas.Considering clinicians perceived barriers and facilitators in the design of telerehabilitation programs can improve long-term implementation and sustainability in rehabilitation services. Telerehabilitation adoption by clinicians is strongly influenced by organisational support, including access to appropriate technology and dedicated time for remote clinical activities. Addressing clinicians’ digital competencies through targeted training can significantly reduce resistance and increase confidence in delivering rehabilitation services via telehealth platforms. Clear clinical guidelines and institutional policies are essential to support consistent and safe use of telerehabilitation in routine practice. Care models combining in-person and remote interventions can improve access to care while maintaining clinical quality, particularly for patients with mobility limitations or living in remote areas. Considering clinicians perceived barriers and facilitators in the design of telerehabilitation programs can improve long-term implementation and sustainability in rehabilitation services.