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

## TL;DR

This study explores how people with chronic musculoskeletal issues in Greece feel about using telerehabilitation, finding that less than half are willing to try it.

## Contribution

The study provides new insights into patient attitudes toward telerehabilitation in Greece, highlighting factors like technology familiarity and education level.

## Key findings

- Less than half of participants (36.9%) were willing to use telerehabilitation.
- Preferred mode of delivery was video-based sessions.
- Willingness was linked to online information-seeking and tech familiarity.

## 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.