Case Managers’ Perceptions About Synchronous Telerehabilitation versus Clinic-based Physical Therapy Services for People with Spinal Cord Injury


  • Steve Kerschke Quality Living, Inc.
  • Karen Hux Quality Living, Inc.



Physical therapy, Service delivery models, Spinal cord injury, Synchronous telerehabilitation, Telehealth


People with spinal cord injury (SCI) require extensive rehabilitation to maximize independence and quality of life. Much of this treatment occurs on an outpatient basis through telerehabilitation or clinic-based services. Synchronous telerehabilitation has become increasingly common in recent years, but many professionals remain reluctant to suggest it when clinic-based services are available. This survey study explored case managers’ perceptions regarding advantages and disadvantages of synchronous telerehabilitation versus clinic-based physical therapy services for people with SCI. Respondents were 89 case managers responsible for service provision coordination. Results showed a significant preference for clinic-based rather than telerehabilitation physical therapy services. Relative experience with the two service delivery models significantly affected perceptions. Only facilitating travel convenience differed significantly as a reason for recommending one service delivery method over the other. The incongruity between perceptions about synchronous telerehabilitation and existing literature about its cost, convenience, and efficacy suggests a need for additional education.



American Telemedicine Association. (2020, October 5). ATA’s Standardized Telehealth Terminology and Policy Language for States on Medical Practice.

Anderson, K., Francis, T., Ibanez-Carrasco, F., & Globerman, J. (2017). Physician’s perceptions of telemedicine in HIV care provision: A cross-sectional web-based survey. JMIR Public Health and Surveillance, 3(2), e31.

Cramer, S. C., Dodakian, L., Le, V., See, J., Augsburger, R., McKenzie, A., Zhou, R. J., Chiu, N. L., Heckhausen, J., Cassidy, J. M., Scacchi, W., Smith, M. T., Barrett, A. M., Knutson, J., Edwards, D., Putrino, D., Agrawal, K., Ngo, K., Roth, E. J., …Janis, S. (2019). Efficacy of home-based telerehabilitation vs in-clinic therapy for adults after stroke. JAMA Neurology, 76(9), 1079-1087.

Cranen, K., Drossaert, C. H., Brinkman, E. S., Braakman‐Jansen, A. L., IJzerman, M. J., & Vollenbroek‐Hutten, M. M. (2012). An exploration of chronic pain patients’ perceptions of home telerehabilitation services. Health Expectations, 15(4), 339-350.

Derakhshanrad, N., Vosoughi, F., Yekaninejad, M.S., Moshayedi, P., & Saberi, H. (2015). Functional impact of multidisciplinary outpatient program on patients with chronic complete spinal cord injury. Spinal Cord, 53(12), 860-865.

Dunphy, E., & Gardner, E. C. (2020). Telerehabilitation to address the rehabilitation gap in anterior cruciate ligament care: Survey of patients. JMIR Formative Research, 4(9), e19296.

Harkey, L. C., Jung, S. M., Newton, E. R., & Patterson, A. (2020). Patient satisfaction with telehealth in rural settings: A systematic review. International Journal of Telerehabilitation, 12(2), 53-64.

Irgens, I., Rekand, T., Arora, M., Liu, N., Marshall, R., Biering-Sørensen, F., & Alexander, M. (2018). Telehealth for people with spinal cord injury: A narrative review. Spinal Cord, 56(7), 643-655.

Kairy, D., Tousignant, M., Leclerc, N., Côté, A. M., & Levasseur, M. (2013). The patient’s perspective of in-home telerehabilitation physiotherapy services following total knee arthroplasty. International Journal of Environmental Research and Public Health, 10(9), 3998-4011.

Lee, A. C. (2020). COVID-19 and the advancement of digital physical therapist practice and telehealth. Physical Therapy, 100(7), 1054-1057.

Levy, C. E., Siverman, E., Jia, H., Geiss, M., & Omura, D. (2015). Effects of physical therapy delivery via home video telerehabilitation on functional and health-related quality of life outcomes. Journal of Rehabilitation Research and Development, 52(3), 361-369.

Matamala-Gomez, M., Maisto, M., Montana, J. I., Mavrodiev, P. A., Baglio, F., Rossetto, F., Mantovani, F., Riva, G., & Realdon, O. (2020). The role of engagement in teleneurorehabilitation: A systematic review. Frontiers in Neurology, 11, 354.

Miller, M. J., Pak, S. S., Keller, D. R., & Barnes, D. E. (2021). Evaluation of pragmatic telehealth physical therapy implementation during the COVID-19 pandemic. Physical Therapy, 101(1), 1-10.

Nas, K., Yazmalar, L., Şah, V., Aydın, A., & Öneş, K. (2015). Rehabilitation of spinal cord injuries. World Journal of Orthopedics, 6(1), 8-16.

Neo, J. H., Teo, S. T., Lee, C. L., & Cai, C. C. (2019). Telerehabilitation in the treatment of frozen shoulder: A case report. International Journal of Telerehabilitation, 11(2), 3-8.

Niknamian, S. (2019). Systematic review on tele-wound-care in spinal cord injury (SCI) patients and the impact of telemedicine in decreasing the cost. Physical Medicine and Rehabilitation Research, 4, 1-6.

Schmeler, M. R., Schein, R. M., McCue, M., & Betz, K. (2009). Telerehabilitation clinical and vocational applications for assistive technology: research, opportunities, and challenges. International Journal of Telerehabilitation, 1(1), 59-72. https://doi:10.5195/ijt.2009.6014

Sineus, W., & Capellan, T. (2019). Physical therapists' perceptions on the use of telehealth in patient care (Publication No. 13886856). [Doctoral dissertation, Florida Gulf Coast University]. ProQuest Dissertations Publishing.

Stein, J., Visco, C. J., & Barbuto, S. (2020). Rehabilitation medicine response to the COVID-19 pandemic. American Journal of Physical Medicine & Rehabilitation. Advance online publication.

Theodoros, D., Russell, T., & Latifi, R. (2008). Telerehabilitation: Current perspectives. In R. Latifi (Ed.), Current principles and practices of telemedicine and e-health (pp. 191-210). IOS Press.

Tsai, J. M., Cheng, M. J., Tsai, H. H., Hung, S. W., & Chen, Y. L. (2019). Acceptance and resistance of telehealth: The perspective of dual-factor concepts in technology adoption. International Journal of Information Management, 49, 34-44.

Turolla, A., Rossettini, G., Viceconti, A., Palese, A., & Geri, T. (2020). Musculoskeletal physical therapy during the COVID-19 pandemic: Is telerehabilitation the answer? Physical Therapy, 100(8), 1260-1264.

Whiteneck, G. G., Gassaway, J., Dijkers, M. P., Lammertse, D. P., Hammond, F., Heinemann, A. W., Backus, D., Charlifue, Sl., Ballard, P. D., & Zanca, J. M. (2011). Inpatient and postdischarge rehabilitation services provided in the first year after spinal cord injury: Findings from the SCIRehab Study. Archives of Physical Medicine and Rehabilitation, 92(3), 361-368.

Yuen, J., Thiyagarajan, C. A., & Belci, M. (2015). Patient experience survey in telemedicine for spinal cord injury patients. Spinal Cord, 53(4), 320-323.




How to Cite

Kerschke, S., & Hux, K. (2021). Case Managers’ Perceptions About Synchronous Telerehabilitation versus Clinic-based Physical Therapy Services for People with Spinal Cord Injury. International Journal of Telerehabilitation, 13(2).



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