Telerehabilitation: How Remote Physiotherapy Compares With In-Person Care

The rapid expansion of remote care from 2020 onward forced a practical question: does physiotherapy delivered by video or phone actually work as well as in-person treatment? Seron and colleagues addressed this with a rapid overview published in Physical Therapy in 2021, synthesising the systematic review literature rather than individual trials.

The team searched Medline/PubMed, EMBASE, and the Cochrane Library, along with PROSPERO, Epistemonikos, and PEDro, and included 53 systematic reviews covering telerehabilitation across cardiac, respiratory, musculoskeletal, neurological, and other populations. Seventeen of these reviews were assessed as having a low risk of bias, and the authors weighted their conclusions accordingly.

Among the more trustworthy reviews, a substantial proportion reported results favouring telerehabilitation compared with in-person rehabilitation or no rehabilitation, while others found no significant differences between remote and face-to-face delivery. Importantly, the absence of a difference is itself clinically useful: it suggests that for many conditions, well-structured remote care does not sacrifice outcomes. The authors concluded that telerehabilitation offers positive clinical results, often comparable to conventional approaches, while noting that evidence quality varies across conditions and outcomes.

For clinical practice, this supports hybrid models of care in which remote consultations extend access for patients facing distance, mobility, or scheduling barriers. Success still depends on sensible triage — matching the delivery mode to the patient's condition, technology comfort, and safety profile — and on structured exercise prescription and follow-up rather than ad hoc video calls.

Key findings

• The authors synthesised 53 systematic reviews of telerehabilitation in physical therapist practice, of which 17 were judged to be at low risk of bias.
• Among the low risk-of-bias reviews, results either favoured telerehabilitation over in-person rehabilitation or no rehabilitation, or found no meaningful differences between delivery modes.
• The overall conclusion was that telerehabilitation offers positive clinical results, in many cases comparable to conventional face-to-face care.
• Evidence quality and applicability vary by condition and outcome, so patient selection, technology access, and safety considerations still guide when remote delivery is appropriate.

Clinical relevance

Rehabilitation clinics can confidently offer remote follow-up and exercise progression as part of standard care pathways, improving access and adherence without compromising outcomes for appropriately selected patients.

Prepared by the Volt Health team as an educational summary of the cited publication. It is not medical advice; assessment and treatment decisions should always be made with a qualified health professional.