# Telerehabilitation for Fall Prevention in Saudi Arabia: Readiness and Predictors Among Physical Therapists

## TL;DR

The study explores factors influencing Saudi physical therapists' readiness to use telerehabilitation for fall prevention, finding that training and international education are key predictors.

## Contribution

Identifies training and international education as critical factors for telerehabilitation readiness among Saudi physical therapists.

## Key findings

- Training in fall prevention is associated with higher belief in telerehabilitation efficacy.
- Education outside Saudi Arabia correlates with greater readiness to implement telerehabilitation.
- Basic familiarity with telerehabilitation does not predict OEP use.

## Abstract

Background: Telerehabilitation can extend fall prevention to underserved groups. Clinician uptake remains limited. We evaluated factors associated with physical therapists’ belief in and readiness to implement the Otago Exercise Program (OEP) via telerehabilitation in Saudi Arabia. Methods: We conducted a national cross-sectional survey of physical therapists (n = 120). Exposures included fall-prevention training, education outside versus inside Saudi Arabia, and familiarity with telerehabilitation. Outcomes were belief in telerehabilitation efficacy for the OEP (5-point Likert) and high readiness, defined as familiarity plus knowledge ≥4 of 5 and belief ≥4 of 5. We utilized ordinal logistic regression for assessing belief and binary logistic regression for assessing readiness. We conducted two-sided tests with alpha equal to 0.05 and prespecified covariates. Sensitivity analyses using penalized likelihood methods confirmed the robustness of the results. Results: The OEP prescription did not differ with telerehabilitation familiarity (χ2 = 0.28; p = 0.597). In multivariable models using complete cases (n = 117; 21 readiness events), fall-prevention training was associated with higher belief (odds ratio [OR] = 3.997; 95% CI = 1.568–10.184; p = 0.004) and higher readiness (OR = 4.520; 95% CI = 1.546–13.210; p = 0.006). Education outside Saudi Arabia was associated with higher readiness (OR = 5.170; 95% CI = 1.435–18.636; p = 0.012). Results were directionally consistent in Firth and pilot-exclusion analyses. Conclusions: Training and international educational exposure were associated with stronger beliefs and greater readiness to implement the OEP via telerehabilitation. Basic familiarity alone was not associated with the OEP use. Programs should prioritize competency-based training and curricular updates to support implementation.