## 4 Discussion
Findings in the literature show the importance of manyfold possibilities and benefits for patients and therapists in telerehabilitation, like flexibility in the location of therapy, different types of interventions, and new feedback possibilities [21]. This is especially important as patients, in general, appear to be worried about less involvement of therapists and a lack of guidance in telerehabilitation [22], which again underlines the benefit of a combined concept with different possibilities of therapy administration and patient-therapist interaction. A concern raised in other studies [11] was the limited quality of teletherapy compared to conventional therapy. This disadvantage was also found in this study, where therapists and patients expressed a higher quality of face-to-face therapy. Reasons for this are the missing control and supervision during synchronous sessions and the lack of efficiency. Nevertheless, the proposed combined therapy concept addresses this issue by offering flexible planning of face-to-face and synchronous sessions. The perceived endorsement and support by peers (subjective norms) for integrating technologies into daily routines strongly impact acceptance [4]. This can also be seen in this study, as therapists and relatives were the first contact points for (technical) support. The integrability in conventional structures can impact product acceptance [5]. The current study showed that telerehabilitation is a great addition to conventional therapy, especially in clinics, but that integration in existing structures holds obstacles. The Austrian healthcare system, with patients treated in a freelance setting, seems to be a better fit for offering telerehabilitation as it can be integrated better into the working structures. For clinics, telerehabilitation must be offered additionally when considering the current structures. Thus, changes in the Slovenian therapy provision system would be necessary to offer telerehabilitation. Extra time for therapists in the clinics would be needed to offer treatment beyond the stay in the clinics. A limitation of the study was implementing the combined therapy concept (face-to-face, video calls, asynchronous training) in the clinics. Most of the therapy took place via video calls, and the most used feature was the exercises. Thus, statements on the quality of this concept were directed towards remote therapy only, which is less effective than on-site therapy. Furthermore, the therapists did not use video calls as therapy sessions but rather as update meetings and questions. A further limitation of the study was the small number of participants. As the platform was newly developed, an initial test in a real-life setting was intended to give first insights into practicability, integrability, and acceptance. Additionally, the duration of the study centers differed due to the different characteristics of the service model (post-clinical vs. freelance setting). These differences might impact the evaluation of the participants, but it was necessary to test the system in different settings. Further studies are needed to prove the effectiveness of the combined therapy concept of face-to-face, synchronous, and asynchronous sessions and to elaborate deeper on the aspects that lead to high acceptance and, thus, usage in the field.