Attitudes of People With Chronic Musculoskeletal Disorders Towards Telerehabilitation: A Cross-Sectional Survey

Abstract

Introduction Chronic musculoskeletal disorders have a significant impact on morbidity, daily functioning, and quality of life. They represent a key priority for intervention, particularly in the context of an aging population and increased life expectancy. Recently, telerehabilitation has been shown to be effective; however, the attitudes of this clinical population toward telerehabilitation have not yet been thoroughly explored in the literature. The aim of this study was to investigate the knowledge, beliefs, and willingness of people with chronic musculoskeletal disorders in Greece to use telerehabilitation. Materials and methods In this cross-sectional study, 160 individuals (95 women and 65 men) with a mean age of 44.1 years and diagnosed with chronic musculoskeletal problems completed a survey. The sample included participants with low back pain (56, 36.9%), overuse tendinopathies (30, 18.8%), neck pain (34, 21.3%), arthritis (14, 8.8%), and upper back pain (3, 1.9%). Participants were recruited from physiotherapy clinics in Athens. The study protocol was approved by the Ethical Committee of the University of West Attica, Greece. The survey questionnaire included 26 items (16 general and 10 telerehabilitation-specific) covering demographic background, familiarization with technology, overall perceptions, willingness to follow telerehabilitation, and preferred mode of delivery. Results The survey was first pilot-tested, and relevant modifications were made. The final version demonstrated acceptable internal consistency (Cronbach's alpha = 0.648). Principal Components Analysis (PCA) revealed a three-factor solution, familiarization with technology, preferred mode of telerehabilitation, and willingness to attend telerehabilitation, with eigenvalues of 2.19, 1.98, and 1.22 respectively, explaining 53.97% of total variance. Overall, fewer than half of the participants (59, 36.9%) reported willingness to follow telerehabilitation. The preferred mode of delivery was video-based sessions. Their perspective towards telerehabilitation appeared to be related to seeking information about their problem online (X² _{(4, N=160)=} 11.1, p=0.03) and technological familiarity (Likelihood Ratio, p=0.048) but not with the specific type of musculoskeletal condition (X² _{(16, N=160)}=12.7, p=ns). Conclusion Telerehabilitation, which leverages technology to deliver rehabilitation services remotely, is indeed seeing its culture constructed and integrated into healthcare systems. However, this survey highlights barriers based on patient attitudes, as less than half of respondents were receptive to the approach. Higher education levels, greater familiarity with technology, and a tendency to seek medical information online were associated with a greater willingness to engage in telerehabilitation. Further research involving larger samples and populations from rural areas across Greece is needed to assess the generalizability of these findings, particularly in regions where health equity is challenged by limited access and technological disparities.

Keywords: attitudes; chronic musculoskeletal disorders; pain management; physiotherapy; survey; tele-physiotherapy; telerehabilitation.

Figure 1. Willingness to use telerehabilitation according to participants’ disorder type (n = 160).

Figure 2. Participants’ preferences on the type of remote rehabilitation according to the diagnosis of chronic musculoskeletal disorder (n = 160).