Experiences of physiotherapists practicing cardiopulmonary telerehabilitation in digital health: a qualitative study

Cardiopulmonary telerehabilitation (CTR) is an innovative approach that improves access to care by allowing physical therapists (PTs) to provide remote monitoring.

This study examines clinical practice and the advancement of telerehabilitation (TR) by enhancing understanding of experiences, barriers, and their effectiveness.

A qualitative study was conducted with eight PTs between May and September 2025. A semi-structured interview technique, developed based on the Theoretical Domains Framework (TDF), was conducted via video conference. Using this inductive approach together with prior texts and written notes, a preliminary coding framework was developed. The interviews were coded independently by two researchers using MAXQDA software, and intercoder reliability was high (Cohen's kappa = 0.82).

The participants were all female physiotherapists; five held a PhD degree and three held a master's degree, with 5-11 years of professional experience and 8-18 months of telerehabilitation experience. The interviews identified thematic codes related to PTs' adaptability, job satisfaction, and challenges in CTR's digital transformation. Key themes included advantages like patient adherence, efficiency, satisfaction, motivation, and technological competence; factors seen as both advantages and disadvantages, such as time flexibility and accessibility; disadvantages like technical issues, reduced physical contact, managing high-risk patients, and virtualization; and recommendations for hybrid models, integrated systems, and national software infrastructures.

Cardiopulmonary telerehabilitation was perceived as an effective and accessible approach that improved patient satisfaction and treatment adherence. However, PTs raised concerns about role transformation, ethical and legal responsibilities, and excessive virtualization. Their preference for a hybrid model highlights the need for face-to-face care, especially for high-risk patients, where safety is critical. The call for user-friendly national software and improved technological literacy underscores that successful CTR implementation requires both infrastructure and professional adaptation.