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Tele-rehabilitation – Another Tool in Your Toolkit

Jan 23, 2019

By: College Practice Advisor

What is tele-rehabilitation?

With the assistance of technology, as a practice advisor I have the good fortune of being able to work remotely from my home office. As technology becomes more advanced and a growing part of our everyday lives, tele-rehabilitation is a mode of practice that more physiotherapists are considering.

Tele-rehabilitation is the provision of physiotherapy services from a distance and involves communication with a patient who is remotely located from the primary physiotherapist providing service.

It incorporates the use of technology such as video conferencing, email, apps, web-based communication or wearable technology.

When is an appropriate time to choose tele-rehabilitation over an in-person interaction?

Tele-rehabilitation may be used to facilitate physiotherapy care by delivering service not otherwise available without compromising care or regulatory accountability, such as for patients located in remote areas where physiotherapy services are not readily available. Imagine the possibilities for improved patient care by a physiotherapist who works in Northern Ontario, limited by travelling great distances to reach patients, who could then treat eight patients in a day rather than two or three. 

There are a few things you should consider before incorporating tele-rehabilitation into your practice. First and foremost, as a physiotherapist you have an accountability to make sure your decisions are always in the patient’s best interest and aligned with your patient’s expectations of care.

What are the special considerations for tele-rehabilitation?

It goes without saying that physiotherapists must comply with all regulatory requirements and deliver the same safe and effective care… but what else should you consider?

You must decide if tele-rehabilitation is the most appropriate and available way to deliver care. Is an in-person, hands on examination needed to complete the assessment and determine a clinical analysis, treatment goals and plan? Will the patient be safe under the care of the physiotherapist within the context of their home or work environment? Are there physical, cognitive or sensory deficits that may make the delivery of physiotherapy care unsafe or ineffective? Can someone be available to assist the patient if needed at their location? How will you protect the safety of your patient’s personal health information?  Are you competent in the use of the technology, its capabilities and its limitations? If you are providing physiotherapy care in another province you must understand and comply with their privacy rules and be registered to practice in that jurisdiction.

Additionally, you should have a plan in place to deal with potential adverse events such as patient medical emergencies, failure of the communication technology or environmental hazards. 

And, don’t forget about consent!  You must have a discussion with the patient and provide all the information they would need to make an informed decision about their care. Be sure to include things like: the difference between in-person and tele-rehabilitation services including options to receive in-person care, the risks to the privacy of their health information and any safeguards in place to reduce these risks. 

For more information, please give the Practice Advice team a call at 1-800-583-5885 (ext. 241) or email We are available to chat with you about the ins and outs of tele-rehabilitation and answer any questions you may have. 

The Canadian Alliance of Physiotherapy Regulators also has several great resources about tele-rehabilitation (including across provincial borders) in practice on their website.

Tele-rehabilitation in Physiotherapy

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  1. Dave | May 14, 2019

    I await the first legal challenge faced by the physiotherapist who uses this and has their practice challenged in a court of law.  

    To compare physio with meds in this respect is missing the point.  For a family doctor to reissue a prescription via telemedicine is one thing.  Assessing a patient using the traditional approach of physiotherapists either requires face-to-face contact, or such an assessment never did, so where does that leave the physio? 

    This topic has never been fleshed out sufficiently and most physios I know won't take the chance of something going wrong when using this, and how easily they could find themselves being sued for negligence.

  2. Heather Anders | Mar 18, 2019
    Thank you CPO for making a statement about this new way of practicing that can transform access, remove barriers, and hopefully provide more options for PTs in their careers.  The right platform is essential to ensure we are meeting all of the proper requirements, and in my opinion, it is a mode for PTs who are already confident and competent with in person care.  I have used the Phzio platform and love it!
  3. Rohit | Jan 24, 2019

    Its a great idea. Many physicians use this method.

    Physiotherapist can also help more patients by this method. For  example if patient is bed ridden or can't drive or weather issues, tgat way patient can video call, get email or call to know what he can do to help himself.

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