Rehabilitative professionals’ experiences and perceptions about telerehabilitation with older people: a qualitative study within the APCARE.TE project

As the population ages, particularly in Italy, telerehabilitation (TR) is increasingly regarded as a potential response to rising healthcare needs. TR can support continuity of care, optimize healthcare resource allocation, and improve access to services. However, its implementation requires changes that extend beyond organizational and technological considerations, positioning TR as a complex and evolving phenomenon in which technology, professional skills, relationships, and social and material contexts are interconnected. Within the APCARE.TE project at the University of Milan, this study examined professionals’ experiences and perceptions of TR with older patients, aiming to understand how this practice of rehabilitation is perceived and to identify associated opportunities, challenges, and training needs. An exploratory qualitative study was conducted with professionals experienced in TR for older adults. Data were collected through individual semi-structured interviews lasting approximately 75 minutes. Participants were recruited using purposive and snowball sampling. The interviews were analyzed using thematic analysis, with two researchers independently reviewing the transcripts to identify recurring meanings, which were subsequently grouped into thematic clusters and emerging themes. Twelve professionals (11 physiotherapists and 1 speech therapist, aged 32–51) from Northern Italy participated. The findings demonstrate a significant gap between the potential of TR and its application in daily clinical practice. Although professionals view TR as a flexible and potentially valuable resource, its use is characterized as fragmented, insufficiently structured, and mainly confined to supporting, monitoring, or following up on treatments initiated in person. Key challenges include the absence of shared guidelines, limited remote assessment tools, organizational and economic barriers, and unequal access to devices and technological infrastructure. The therapeutic relationship remains a central concern: professionals express apprehension about distancing and depersonalization, yet also acknowledge the benefit of accessing patients’ home environments through technology. Caregivers are identified as essential for the sustainability of TR. Professionals report a strong need for integrated training that combines technological, rehabilitative, and relational competencies. TR is perceived as a promising yet complex practice that challenges traditional rehabilitation approaches, professional roles, and care relationships. The findings highlight the necessity for structured, multidimensional training pathways that address not only technical skills but also relational, organizational, and planning dimensions, to ensure that TR is not merely a digital replication of conventional rehabilitation practices.