Physiotherapists’ Perception of and Readiness to Use,Telerehabilitation for Musculoskeletal Disorders in Malaysia: A Cross-Sectional Study

Abstract

Introduction:

Musculoskeletal ailments exert a significant impact on global populations. To address challenges posed by geographical constraints and financial limitations, physiotherapists have explored and found telerehabilitation to be a viable solution. Despite its proven effectiveness in clinical practice, the integration of telerehabilitation has been sluggish. This cross-sectional survey sought to delve into the perspectives and readiness of physiotherapists in Malaysia regarding telerehabilitation for musculoskeletal disorders.

Methods:

A customized survey instrument was developed and evaluated for face validity and reliability. The 36-item questionnaire was distributed through the Google Form platform, targeting respondents via social media channels such as Facebook and WhatsApp. Data analysis used descriptive statistics (frequency and percentage).

Results:

The survey garnered responses from 271 physiotherapists. A majority (76.3%, n = 202) expressed agreement regarding the potential benefits of telerehabilitation in physiotherapy practice. About 77% of the respondents also showcased greater readiness for monitoring client progress through telerehabilitation as opposed to assessment and treatment. Notable benefits identified by respondents included preventing cross-infection (98.5%) and reducing travel time for both clients (94.0%) and physiotherapists (90.6%).

Conclusion:

The study reveals that physiotherapists in Malaysia exhibit positive attitudes and preparedness for implementing telerehabilitation in managing musculoskeletal conditions.

Introduction

Musculoskeletal disorders are identified as one of the world’s leading causes of disease burden.^1,2 In 2016, musculoskeletal disorders accounted for the highest health expenditures in the United States at $380 billion.³ Nonpharmacological interventions such as those offered by physiotherapists are recommended as an essential approach in the management of musculoskeletal disorders.⁴ There has also been a shift in physiotherapists’ roles and pathways to ensure higher competency in meeting this growing musculoskeletal disease burden.⁵ The main challenges faced by physiotherapists include geographical barriers,⁶ budget and availability barriers,⁷ and lack of treatment adherence.⁸ Consequently, telerehabilitation has been considered a solution to these problems. The use of information and communication technologies (ICT) to provide rehabilitation to both children and adults where suitable is known as telerehabilitation.⁹ The advantages of telerehabilitation have been discussed, including increased access to rehabilitation services⁸ and reduced healthcare costs,¹⁰ and how it has been especially beneficial during the COVID-19 pandemic. Although telerehabilitation has the potential to improve the quality of physiotherapy services, its adoption rates have been reported to be low in both developing^11,12 and developed countries.¹³

The perceptions of physiotherapists regarding the utilization of telerehabilitation in the management of musculoskeletal disorders have been the subject of investigation across diverse geographical regions. Notably, a few exploratory studies, conducted in Australia and Sri Lanka, focused on understanding the perspectives of physiotherapists in delivering exercise therapy for osteoarthritis knees via telephone.^14
–16 Similarly, a separate study conducted in Spain delved into the attitudes and viewpoints of physiotherapists regarding the implementation of telerehabilitation for treating chronic low back pain.¹⁷ The results from both studies demonstrated a positive perception of physiotherapists toward implementing telerehabilitation in the musculoskeletal physiotherapy practice. The outcomes from these studies underscored a prevailing sentiment of enthusiasm and endorsement among physiotherapists for the integration and utilization of telerehabilitation methodologies within the sphere of musculoskeletal physiotherapy practice. These findings signify a growing acceptance and positive reception of telerehabilitation as a viable and effective approach in the realm of musculoskeletal care, suggesting a promising avenue for its incorporation into clinical practice.

There is limited evidence of physiotherapist’s perception of the use of telerehabilitation in Malaysia. While a previous study¹⁸ explored physiotherapists’ awareness and acceptability of telerehabilitation, it did not extend to musculoskeletal disorders. There is a knowledge gap in the literature concerning physiotherapists’ perception of, and readiness to use, telerehabilitation in the management of musculoskeletal disorders. Therefore, this study aimed to address this knowledge gap in Malaysia.

Methods

STUDY DESIGN AND SETTING

An online cross-sectional survey was performed to enable the remote gathering of data from physiotherapists residing in both urban and rural settings without the need to travel to a specific location. The survey, disseminated in the English language, was administered using a Google Form, encompassing a consent form, a personal information sheet, and a questionnaire. The data collection period for this survey spanned from March to June 2022. This study obtained ethical approval from Research Ethics Committee, University Kebangsaan Malaysia (UKM PPl/111/8/JEP-2021-830), and NMRR (NMRR ID-21–01970-Q2S (IIR).

PARTICIPANTS

Invitations were extended to all physiotherapists across Malaysia to participate, using convenience sampling methodology. The inclusion criteria encompassed physiotherapists employed in either governmental or private sectors with a minimum of two years of professional experience. This study was inclusive and did not impose any specific exclusion criteria.

RECRUITMENT, CONSENT

As there is no central database for Malaysian physiotherapists, various means were used to reach potential participants across Malaysia. The study and questionnaire were promoted via the Malaysian Physiotherapy Association (MPA) Facebook page. Respondents provided informed consent electronically through the survey’s first question before proceeding to the subsequent questions. The respondents provided informed consent electronically in the first question of the survey before starting it.

SAMPLE SIZE

The sample size estimated at 271 respondents was calculated according to previous research,¹⁹ with using a 95% confidence level and 5% of desired precision.

QUESTIONNAIRE DEVELOPMENT AND VALIDATION

A survey instrument was crafted using insights from previous research on this subject.^19,20 Formal, written permission was obtained from the original authors of the questionnaire for adaptation. Rigorous measures including content and face validation, and exploratory factor analysis, were performed before the dissemination of the questionnaire. A pilot study involving a sample size of 25 to 40 physiotherapists was then conducted to refine and develop the instrument.^21,22

CONTENT VALIDATION

Content validation was performed before the commencement of this study. The questionnaire was emailed to a panel of six physiotherapists who were asked to rate and comment on the relevance of each item on a scale of 1 to 4. The lowest score 1 indicates that the item is not relevant to the measured domain, scores 2 and 3 indicate that the item is somewhat relevant or fairly relevant to the measured domain, and a score of 4 indicates that the item is highly relevant to the measured domain. The criteria for the experts in content validation were senior physiotherapists who had worked for more than 10 years. Before calculating the Content Validity Index (CVI), the relevance rating was recorded as 1 with a relevance scale of 3 or 4 or 0 with a relevance scale of 1 or 2. The Item Content Validity Index (I-CVI) and Scale Level Content Validity Index (S-CVI/Ave) were calculated. Items with CVI scores less than 0.70 were eliminated, and those with scores between 0.70 and 0.79 were modified accordingly based on the recommendations.²³

FACE VALIDATION

For face validity, ten physiotherapists with at least 2 years of working experience represented the target population. They were invited to review and comment on the clarity and comprehension of the instructions and language used in the items. Physiotherapists rated each item on a scale of 1 to 4. The item that was not clear and understandable to the measured domain will score 1, which indicated the lowest score, while scores 2 and 3 indicated that the item is somewhat clear and understandable and the item is clear and understandable and score 4 indicated that the item is very clear and understandable. The Item Face Validity Index (I-FVI) and Scale Level Face Validity Index (S-FVI/Ave) were calculated. The rating of 1 or 2 was rated as 0, and otherwise as 1 for the FVI indices. The acceptable FVI value is at least 0.83.²⁴

EXPLORATORY FACTOR ANALYSIS (EFA)

An EFA was performed to examine the factor structure of the items. Principal axis factoring with the Promax rotation method was used because it places less emphasis on dimensionality.²⁵ The Kaiser–Meyer–Olkin (KMO) test was used to determine sampling adequacy. According to the literature, a KMO value greater than 0.60 indicated adequate data and achieved significance in Bartlett’s test for conducting an EFA.²⁶ The minimum acceptable factor loading was greater than 0.3.²⁷ Initially, three domains were proposed for this questionnaire. However, these items revealed only two domain structures. The titles were changed after the two domains were identified, namely, perceptions and readiness of telerehabilitation and perceived benefit of telerehabilitation for clients with musculoskeletal disorders. Subsequently, internal consistency/reliability was assessed using Cronbach’s alpha test. A value of more than 0.7 indicates good internal consistency.²⁸

FINAL QUESTIONNAIRE

The questionnaire comprised five sections. Section A inquired about sociodemographic information. This section consisted of 11 closed sociodemographic questions regarding respondents’ age, gender, years of working experience, and level of education. Section B focused on technological background information. The third part of the questions in this section, which used a 5-point Likert scale from always to never, was created to collect information on respondents’ technological backgrounds. Section C gathered information about the perception and readiness of telerehabilitation for musculoskeletal clients. This section consisted of eight questions with a 5-point Likert scale ranging from strongly agree to strongly disagree, pertaining to the respondents’ perceptions and readiness regarding telerehabilitation for musculoskeletal disorders. Section D focused on telerehabilitation’s perceived benefits for musculoskeletal disorders. This section contained eight 5-point Likert scale questions, ranging from strongly agree to strongly disagree, to collect opinions on the benefits. The last section was on experiences in telerehabilitation. Section E consisted of three questions to gather respondents’ information regarding their telerehabilitation experience.

DATA COLLECTION

The questionnaire was administered electronically and hosted using Google Forms. All questions were set to require a response before respondents could proceed to the next question. This ensured that all sections are were filled out and that no data are were missing or incomplete. The author disabled the Google link on reaching the targeted number of respondents.

STATISTICAL ANALYSIS

Data from the completed survey were downloaded to a Microsoft Excel spreadsheet. Descriptive statistics, frequencies, and percentages were used to summarize and describe the data.

VALIDITY OF THE QUESTIONNAIRE

Content validity index

The questionnaire was validated through content validation, face validation, and a pilot study. Six physiotherapists were invited to participate in content validation. There was no consensus agreement for the I-CVI in the first round of content validation, except all items in experience in telerehabilitation section achieved more than 0.83. A total of three items in the first round of content validation achieved an I-CVI value of 0.67. The acceptable CVI value required by six experts was at least 0.83.²³ Thus, a second round of content validation was undertaken with the same expert panels to attain a higher CVI value by altering the questionnaire items based on their feedback. All S-CVI values were greater than 0.83. Table 1 summarizes the CVI values for the items requiring further action in both the first and second rounds of content validation.

Table 1.

Modified Items in the First and Second Round of Content Validation

SECTION	FIRST ROUND			SECOND ROUND
SECTION	ITEM	I-CVI	INTERPRETATION	ITEM	I-CVI	INTERPRETATION
Technological Background Information	1	0.67	Removed
Technological Background Information	4	0.83	Modification
Perceived benefit of using telerehabilitation	1	0.83	Modification	2, 3	0.83	Modification
Perceived benefit of using telerehabilitation	4,5	0.67	Removed
Perception about telerehabilitation	2,3,5 and 6	0.83	Modification	2,3,6,8,10	0.83	Modification
Readiness about telerehabilitation	4,10 and 11	0.83	Modification	2	0.83	Modification

I-CVI, Item Content Validity Index.

Face validity index

Ten candidates were selected from physiotherapists who had worked for at least 2 years of experiences. They were required to review the questionnaire, check all items, and provide comments to improve clarity and comprehensibility. The overall FVI of clarity and comprehension among physiotherapists was more than 0.83. All S-FVI values for the items requiring modifications are presented in Table 2.

Table 2.

Modified Items in the Face Validation

SECTION	ITEM	I-FVI	INTERPRETATION
Technological background information	4	0.90	Modification
Perceived benefit of using telerehabilitation	2,4	0.90	Modification
Perception about telerehabilitation	2,7	0.90	Modification

I-FVI, Item Face Validity Index.

EXPLORATORY FACTOR ANALYSIS

This pilot study was conducted at a physiotherapy department of large (1005 beds) government hospital to ensure that the questions were clearly written, easily understood, and unambiguous. Twenty-five physiotherapists agreed to participate via the Google Form link sent to them. The minimum estimated sample size was 24.²¹ The Cronbach’s alpha for the questionnaire was determined to be 0.828 and 0.825.

RESPONSE AND SAMPLE CHARACTERISTICS

Two hundred seventy-one physiotherapists from different clinical settings responded to the survey. Six incomplete responses from the dataset were removed during data cleaning. The respondents’ sociodemographic information is presented in Table 3. Most of the respondents were females (n = 181, 68.3%) and had a diploma in physiotherapy as their highest level of education (n = 129, 48.7%), with the bachelor’s degree coming second (43.4%). The group of physiotherapists aged 30–39 (n = 175, 66%) years was the largest among the age groups. Approximately 69% of physiotherapists reported working with clients who have musculoskeletal disorders. Just over half of the physiotherapists worked in a government hospital (n = 136, 51.4%). Most physiotherapists (n = 200, 75.5%) reported no prior experience with telerehabilitation, with a slightly higher percentage of physiotherapists willing to use telerehabilitation in their practice (n = 212, 80.0%).

Table 3.

Respondent’s Demographics Characteristics

VARIABLE	n (%)
Gender
Male	84 (31.7)
Female	181 (68.3)
Age (Years)
Under 29	37 (14)
30–39	175 (66)
40–49	51 (19.3)
50 and above	2 (0.7)
Highest level of education
Diploma	129 (48.7)
Advanced diploma	10 (3.8)
Bachelor’s degree	115 (43.4)
Master	11 (4.1)
Working experience (Years)
Under 5	34 (12.8)
6–10	89 (33.6)
11–15	98 (37.0)
16–20	33 (12.5)
Above 21	11 (4.2)
Clinical population
Musculoskeletal	182 (68.7)
Non musculoskeletal (Paediatrics, Geriatric, Neurology, Psychiatric, NCD, Phototherapy, ICU, Mixed cases)	83 (31.3)
Clinical setting
Government hospital	136 (51.4)
Government Clinic	71 (26.8)
Private center	34 (12.8)
Private Hospital	12 (4.5)
Others (Nurses home, Academic Institution, Freelance)	12 (4.5)
Have you ever used telerehabilitation
Yes	65 (24.5)
No	200 (75.5)
Are you willing to use telerehabilitation in your practices?
Yes	212 (80.0)
No	53 (20.0)

TECHNOLOGICAL BACKGROUND INFORMATION

The technological background information of the physiotherapists is indicated in Table 4. The results demonstrate that 58.1% of the respondents always used electronic devices such as computers, handphones, and tablets for work purposes. In addition, 63.8% of physiotherapists reported frequently accessing the internet for work. Just around half of physiotherapists used email for work purposes. The most common sources of internet information accessed by physiotherapists for work purposes were websites (n = 194), online courses (n = 188), and social media (n = 155).

Table 4.

Technological Background Information

VARIABLE	n (%)
Do you use electronic devices such as computers, handphones, tablets etc., for work purposes?
Always	154 (58.1)
Often	58 (21.9)
Sometimes	47 (17.7)
Rarely	6 (2.3)
Never	0 (0)
Do you use email for work purposes?
Always	130 (49.1)
Often	67 (25.3)
Sometimes	47 (17.7)
Rarely	18 (6.8)
Never	3 (1.1)
Do you access the internet for work purposes?
Always	169 (63.8)
Often	61 (23.0)
Sometimes	30 (11.3)
Rarely	4 (1.5)
Never	1 (0.4)
Sources of information have you accessed for work purposes (can choose more than one)
Published research papers	148 (55.8)
Professional association (eg: Malaysian Physiotherapy Association)	111 (41.9)
Online courses	188 (70.9)
e- books	100 (37.7)
Discussion with other health professionals	107 (40.4)
Intranet hospital/ clinic	106 (40.0)
Websites	194 (73.2)
Social media	155 (58.5)
Blog	27 (10.2)
None	0 (0.0)

PERCEPTIONS AND READINESS ABOUT TELEREHABILITATION FOR CLIENTS WITH MUSCULOSKELETAL DISORDERS

As shown in Table 5, approximately 76% of physiotherapists recognized the beneficial impact of telerehabilitation on the physiotherapy profession. However, 21.1% reported to be unsure. Seventy-one percent of physiotherapists believed that the combination of telerehabilitation with conventional physiotherapy would be better than conventional physiotherapy care on its own. Seventy-six percent of physiotherapists indicated that telerehabilitation could allow greater access to physiotherapy. Almost half of the physiotherapists (45.7%) stated that their hospital/department did not have the facilities to provide telerehabilitation. Similarly, 43.0% of physiotherapists reported a lack of resources, such as an e-flyer in their hospital/department. Precisely 57.0% of physiotherapists were ready to use telerehabilitation to provide assessments, while 56.7% reported to be ready to use telerehabilitation to provide treatment. Approximately, a total of 77.4% of physiotherapists are ready to use telerehabilitation to monitor client progression.

Table 5.

Perceptions and Readiness About Telerehabilitation for Clients with Musculoskeletal Disorders

STATEMENT	n (%)
STATEMENT	STRONGLY AGREE	AGREE	UNSURE	DISAGREE	STRONGLY DISAGREE
Do you think telerehabilitation will bring benefits to physiotherapy	67 (25.3)	135 (51.0)	56 (21.1)	7 (2.6)	0 (0)
Do you think the combination of telerehabilitation with conventional physiotherapy would be better than conventional physiotherapy care?	71 (26.8)	136 (51.3)	40 (15.1)	17 (6.4)	1 (0.4)
Telerehabilitation can allow greater access to physiotherapy?	44 (16.6)	158 (59.6)	44 (16.6)	19 (7.2)	0 (0)
My hospital/ department doesn’t have a facility such as audio devices, zoom apps, etc., to provide telerehabilitation services to the client.	40 (15.1)	81 (30.6)	16 (6.0)	102 (38.5)	26 (9.8)
My hospital/ department has resources such as e- flyer and eBook to provide telerehabilitation services to the client.	18 (6.8)	67 (25.3)	66 (24.9)	87 (32.8)	27 (10.2)
I am ready to use telerehabilitation to provide assessment.	33 (12.5)	118 (44.5)	70 (26.4)	38 (14.3)	6 (2.3)
I am ready to use telerehabilitation to provide treatment.	33 (12.5)	117 (44.2)	65 (24.5)	45 (16.9)	5 (1.9)
I am ready to use telerehabilitation to use telerehabilitation to monitor clients’ progression	52 (19.6)	153 (57.8)	37 (14.0)	20 (7.5)	3 (1.1)

PERCEIVED BENEFITS OF USING TELEREHABILITATION FOR CLIENTS WITH MUSCULOSKELETAL DISORDERS

Table 6 shows the respondents’ responses toward the perceived benefits of telerehabilitation. Physiotherapists significantly agreed with three statements about the perceived benefits of telerehabilitation for clients with musculoskeletal disorders. Namely, that telerehabilitation could help in avoiding contact with a potential cross-infection spreader (98.5%), it would reduce travel time for clients (94.0%), and reduce travel time for physiotherapists who traveled to multiple clinical settings (90.6%). Fifty-four percent of physiotherapists felt unsure whether telerehabilitation would improve the satisfaction level of clients with physiotherapy services. Approximately 78% of physiotherapists believed telerehabilitation offers flexibility in physiotherapy care. The survey revealed that 60% agreed telerehabilitation is a feasible approach for physiotherapists to manage musculoskeletal impairments and disorders. Just under 60% of physiotherapists believed that telerehabilitation had the potential to reduce the number of defaulters. About 42% of physiotherapists consider telerehabilitation will improve the satisfaction level of physiotherapists. According to the data presented in Table 7, physiotherapists who had experience in telerehabilitation commonly provided several resources to clients. These included videos (n = 49) and website links (n = 30). Almost half of the physiotherapists (46%) who experienced telerehabilitation reported spending less time in telerehabilitation consultation for a comparable condition than face-to-face care. In addition, 63.1% of physiotherapists reported spending fewer telerehabilitation sessions than on face-to-face care.

Table 6.

Perceived Benefits of Using Telerehabilitation for Clients with Musculoskeletal Disorders

STATEMENT			n (%)
STATEMENT	STRONGLY AGREE	AGREE	UNSURE	DISAGREE	STRONGLY DISAGREE
Telerehabilitation is a feasible approach for physiotherapy services to manage musculoskeletal impairment and disorders	29 (10.9)	129 (48.7)	70 (26.5)	34 (12.8)	3 (1.1)
Telerehabilitation can help in reducing travel time for physiotherapists who travel to multiple clinical settings	90 (34.0)	150 (56.6)	22 (8.3)	3 (1.1)	0 (0)
Telerehabilitation will reduce travel time for client	91 (34.3)	158 (59.7)	13 (4.9)	3 (1.1)	0 (0)
Telerehabilitation offers flexibility in how physiotherapy care is delivered.	65 (24.6)	141 (53.2)	43 (16.2)	16 (6.0)	0 (0)
Telerehabilitation can help in avoiding contact with a potential cross-infection spreader.	126 (47.5)	135 (51.0)	1 (0.4)	3 (1.1)	0 (0)
Telerehabilitation will improve the job satisfaction level of physiotherapists.	31 (11.7)	80 (30.2)	103 (38.9)	44 (16.6)	7 (2.6)
Telerehabilitation will not improve the satisfaction level of clients towards physiotherapy services	20 (7.5)	59 (22.3)	142 (53.6)	37 (14.0)	7 (2.6)
Telerehabilitation may have the potential to reduce the number of defaulters.	39 (14.7)	113 (42.7)	78 (29.4)	34 (12.8)	1 (0.4)

Table 7.

Experience in Telerehabilitation

VARIABLE	n (%)
What resources are generally provided to clients during telerehabilitation? (can choose more than one answer)
Videos	49 (69.2)
Electronic information sheets	29 (44.6)
website link	30 (46.2)
Smartphone apps	21 (32.3)
Recommended suitable book/ reading materials	15 (23.1)
Written information	29 (44.6)
How does the duration of your telerehabilitation sessions compare to face-to-face care?
More time than face to face care	11 (16.9)
The same amount of time	20 (30.8)
Less time than face to face care	30 (46.1)
Unsure	4 (6.2)
How many times do you generally see clients with telerehabilitation compared to face-to-face care?
More than face to face care	5 (7.7)
The same amount of time	11 (16.9)
Less than face to face care	41 (63.1)
Unsure	8 (12.3)

Discussion

This is the first known study to investigate the perception of and readiness to use telerehabilitation in managing musculoskeletal disorders by physiotherapists in Malaysia. In the conducted survey, 75.5% had never used telerehabilitation, and 80% were willing to implement it in their practices. Lack of exposure to telerehabilitation in Asian countries is not uncommon. Research conducted among nurses in China reported that 55.6% did not have experience with telerehabilitation, yet 91.9% were willing to provide telerehabilitation.²⁹ One reason for their willingness to engage in telerehabilitation, despite their lack of experience, may be their familiarity with technology. The majority of respondents were 30–39 years old, relatively young, and tech-savvy in electronic devices and internet access.³⁰

Our findings build on the previous research¹⁸ that Malaysian physiotherapists recognized the benefits of telerehabilitation. Respondents agreed that telerehabilitation offers greater access to physiotherapy services, the finding which is similar to a study conducted in Nigeria, which reported that telerehabilitation could bridge the gap between the geographical distance of clients and healthcare facilities.³¹ The disparate geography of Malaysia could lead to limited access to healthcare services for individuals residing in rural areas. Consequently, patients in rural areas must rely on urban healthcare services, necessitating time-consuming travel.¹⁷ The findings showed that 94% of physiotherapists agreed that telerehabilitation would save travel time for clients with musculoskeletal disorders. Previous studies conducted in Saudi Arabia,³² the United States,³³ and Canada³⁴ reported similar findings.

The impact of the COVID-19 pandemic was also reflected in our study as almost all respondents (98.5%) agreed telerehabilitation can help avoid contact with a potential spreader. The role of virtual healthcare delivery mode in infection prevention during COVID- 19 has been highlighted.^35,36 In addition, in a cross-sectional study in Iceland, 92.7% of physiotherapists considered telerehabilitation an effective step in eliminating direct contact with potential COVID-19 spreaders.³⁷

Our research found conflicting reports on physiotherapists’ views on telerehabilitation. While only half of the physiotherapists were ready to provide assessment and treatment via telerehabilitation, 77.4% reported using telerehabilitation to monitor client progression. One explanation for this finding might be that physiotherapists may initially prefer a face-to-face approach as part of establishing rapport, and limitations in virtual healthcare delivery mode may present in performing physical examination.¹⁴ However, once this occurs, ongoing monitoring, progression of exercises, and continuity of care can be delivered by online healthcare delivery mode.³⁸ The acceptance of telerehabilitation is not always universal¹³ and in itself may be a critical factor in its success or failure.³⁹

This study has several inherent limitations. As the study’s survey was open to all physiotherapists, perceptions and readiness may differ based on their individual clinical experiences. Given the voluntary participation in this research, physiotherapists with a strong interest in telehealth were more likely to participate in the survey. Therefore, we acknowledge that the results may not reflect the perception of all physiotherapists in Malaysia. Recruitment was conducted online through social media and personal contacts.

Consequently, we were unable to determine the response rate and how likely our respondents potentially had adequate levels of digital literacy. Notably, most respondents were from the government sector. Future studies could include more physiotherapists from the various sectors to capture their perceptions and readiness toward telerehabilitation. It is also recommended that future studies explore the possible challenges in the implementation of telerehabilitation in Malaysia.

Conclusions

This survey provided foundational information on physiotherapists’ perceptions and readiness to provide physiotherapy care via telerehabilitation for clients with musculoskeletal disorders in Malaysia. Although exploratory, the results were generally encouraging. The positive perceptions of, and perceived benefits from, telerehabilitation reported in our research could be leveraged to strengthen the Malaysian physiotherapy workforce further to deliver high-quality telerehabilitation services for common musculoskeletal disorders. This can be achieved by upskilling the workforce through educational initiatives (such as short courses) and embedding telerehabilitation in physiotherapy curricula.

Footnotes

Authors’ Contributions

L.L.S., S.S., and D.K.A.S. conceptualized the project. The study was designed using the L.L.S., S.S., and D.K.A.S. Data were collected by L.L.S. Formal analyses were performed by L.L.S, S.S., and D.K.A.S. The draft of the article was prepared by L.L.S, S.S, and D.K.A.S, and S.K. reviewed the article. All authors have read and approved the final version of the article.

Funding Information

This study did not receive any funding.

Disclosure Statement

The authors completed the ICMJE Form for Disclosure of Potential Conflicts of interest and reported no conflicts of interest.

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