Telerehabilitation in Physical Therapist Practice: A Clinical Practice Guideline From the American Physical Therapy Association

This clinical practice guideline (CPG) from the American Physical Therapy Association provides evidence-based recommendations for the delivery of physical therapy services via telerehabilitation. Developed by an international group of experts, the guideline synthesizes research from systematic reviews and clinical studies to guide clinicians, patients, and policymakers on the efficacy, safety, and implementation of remote care. The CPG emphasizes that telerehabilitation is a viable, effective alternative or supplement to traditional in-person physical therapy.

The guideline development group conducted a comprehensive review of literature published between 2010 and 2022, focusing on randomized controlled trials, systematic reviews, and qualitative studies. The evidence was appraised using the GRADE system to assess quality and strength. The CPG addresses seven key recommendations covering the impact of telerehabilitation, preparation, implementation, and the identification of barriers and facilitators from both patient and provider perspectives.

The CPG concludes that telerehabilitation is at least equivalent to in-person care for patient satisfaction and often superior regarding attendance and adherence. While diagnostic accuracy for certain musculoskeletal and neurological conditions is comparable to in-person assessments, the guideline highlights the importance of shared decision-making. Clinicians are encouraged to assess individual patient needs, including access to technology and the necessity of caregiver support, to ensure safe and effective care. Importantly, the evidence indicates no increased risk of adverse events associated with the remote mode of delivery compared to in-person visits.

As digital health continues to evolve, this CPG serves as a critical resource for standardizing practice and reducing unwarranted variations in care. It provides a framework for physical therapists to integrate telerehabilitation into their practice, potentially increasing access to care for patients in rural or underserved areas, while maintaining high standards of safety and professional ethics. The guideline also identifies significant gaps in current knowledge, signaling the need for future research across diverse patient populations and age groups.