Table 3.

Study Characteristics

Source	Year	Country	Research aim	Research design [quality rating]	Sample size Age (mean, variance)	Sample Gender (male n; female n)	Sample primary Diagnosis/ Condition	Measures used in study*	Intervention (brief description)	Disciplines involved in intervention	Technologies used in delivery	Site where rehab received	Outcome
PATIENT INTERVENTION STUDIES
Alasfour & Almarwani	2020	Saudi Arabia	To determine if the studyspecific Arabic smart phone app ‘My Dear Knee’ increases exercise program adherence.	RCT App group n=20; control group C=20) CASP: Good	N=40 Mean age 54.4 (+/4.33 years)	40 females	Osteoarthritis in knee	Self-reported adherence to prescribed home exercise program; Arabic numeric pain rating scale; Arabic version of the reduced Western Ontario, McMaster Universities Osteoarthritis Index Physical Function subscale, and Five-Times Sit- To-Stand Test scores.	6 weeks exercise program with home exercise - paper resource versus smart-phone-app	Physiotherapist only	Smart phone Author- designed app ‘my dear knee'	home	App group has reduced pain, increased physical function, increased lower limb strength and increased program adherence compared to control
Azma et al	2018	Iran	To evaluate the impact of telerehabilitation office based physiothera py versus conventional therapy on function and OA symptoms.	RCT CASP: Moderate	76 randomized; N=54 completed 58.25 years (+/-7.41; range 45 60 years)	n=21 males n=33 females Reported as a % of all partici-' pants but unclear if this refers to all randomis ed or all completed — completed reported here	Knee osteoarthrit is	Persian version of Knee injury and Osteoarthritis Outcome Score (KOOS); Visual Analogue Scale (VAS); Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) (pain, AdL, symptom, sport, QoL subscales)	18 sessions/6 weeks each group. Telerehabilitation group received face to face instruction in exercises, information pamphlet, then home practice, with weekly monitoring call by doctor by phone; Control group: passive therapies physiotherapy in clinic services.	Telerehabilitation group: physical therapist instruction then physical rehabilitation specialist doctor follow up; Control group: physical therapist at clinic.	Phone — assisted telerehabilitation call on weekly basis versus physical therapy clinic	Both groups in clinic instruction, then home tele- rehabilit ation group versus in-clinic physiotherapy	Both groups improved on pain and function; no significant difference between telerehabilitation and in-clinic service — telerehabilitation equivalent outcomes to traditional clinic service
Golebowicz et al.	2015	Israel	To determine if an ergonomic intervention followed by electronic biofeedback self-practice for 4–6 weeks at work reduced upper limb musculoskeletal symptoms including pain.	Observational prospective cohort study CASP: Moderate	N=12 34.25 years (2458)	6 males; 6 females	Computer operators with work — related musculoskeletal disorders	Biodemographic questionnaire; Pre-post PROM Standard Nordic Questionnaire; pre-post PROM Swedish Demand Control Support Questionnaire; pre-post Rapid Upper Limb Assessment; surface electromyogra phy; pre-post physical examination for upper extremity symptoms.	Workplace assessment and adjustment; provision of biofeedback and installation of program on each person's workstation; for selfpractice use 4–6 weeks	Occupational therapist only	Exercise data via a telerehabilitation biofeedback system	Workplace	Upper extremity symptoms reduced, regions of pain and activity limitations from pain reduced, body posture improved
Kalron et al.	2018	Israel	To evaluate effects of telerehabilitation on mobility in people following hip surgery.	RCT CASP Good	N=40 randomized; 32 completed mean age controls 67.3 (SD 9.5); telerehabilitation of 65.7. (7.8)	Gender data provided for: 17 males; 19 females	hip surgery	The Timed Up and Go test, 2min walk test, 10-m walk test, sit to stand test, walking speed, and mean step length.	6 weeks, 3 sessions/week telerehabilitation versus control intervention group	Physiotherapist	video-based telerehabilitation program.	home	Telerehabilitation (n=15) significantly higher in all mobility outcomes than control (n=17)
Kargar et al.	2020	Iran	To evaluate the impact of telerehabilitation (handburn selfcare educational application) versus conventional therapy.	RCT CASP: Moderate	N=60 30 in each group; Telerehabilitation 38.2 years (+/11.7) Control 43.6 years (+/−12.6)	44 males; 16 females	Burns	Type of burn; The BurnSpecific Health Scale-Brief (BSHS-B) (includes QoL scales)	Both groups receive selfcare training during admission and at discharge provided inperson by nurse with information pamphlet; Telerehabilitation group also received instruction on the hand selfcare app which included: educational materials, opportunity to send pictures via chat and messaging system; Q&A answering; referral to clinic if needed)	Control group: nurses. App group nurses plus app clinicians plus medical professionals and ‘health care providers' (e.g., surgeons, nurses, physiotherapists, and nutrition consultants).	Author developed burns self-care app	Home	Within group, QoL, physical psychological and social dimensions and aspects of QoL improved for; both groups, QoL, physical pyshological and social dimensions and aspects of QoL significanty higher for app group
Kizony et al.	2017	Israel	To evaluate the feasibility of postdischarge 2- year hybrid synchronous - asynchronous telerehabilitation to improve upper extremity range of motion, strength, endurance, and functional ability.	Retrospective medical record audit CASP: Good	N=82 (ABI group 59.1, +/15.5, 2282 years) (MS group 57.4, +/8.2, 44–68 years)	46 males; 36 females	Acquired Brain Injury (n=74) and Multiple Sclerosis (n=8)	National Institutes of Health Stroke Scale (NIHSS); Mini-Mental State Exam (MMSE); Trail Making Test (TMT, parts A and B); Fugl- Meyer Assessment (FMA); Motor Activity Log (MAL); System Usability Scale (SUS); Focus group (on experience)	CogniMotion System which gave a hybrid synchronous - asynchronous telerehabilitation experience to improve upper extremity range of motion, strength, endurance, and functional ability	Physio or occupational therapist	CogniMotion System based program (system technical details reported in paper)	Home (with remote connectio n to clinician via call centre)	Program evaluated as usable and enjoyable; good user satisfaction; significantly improved in FMA, shoulder flexion.
Nabutovsky, Ashri et al.	2020	Israel	To evaluate the feasibility, safety, and effectiveness of a cardiac rehabilitation exercise program	Prospective observational cohort study CASP: Good	N=22 Mean age: 52.7, +/0.81	17 males; 5 females	Coronary artery disease	Smart-watch recorded minutes of aerobic exercise >70% VO2Max per week, no. resistance training sessions per week, patient questionnaires, safety = no. doctors/hospital visits, stress-test prepost, step count, no. exercise sessions >10 min per month, physiological measures, Borg Rating Perceived Exertion Scale, PHQ-9, PROMISE 10. Mobile application usage (time), remote patient management time.	Six-month secondary prevention cardiac exercise program using mobile phone applications and multidisciplinary cardiac control center services	Telerehabilitation cardiac specialist, dietitian, psychologist, exercise physiologist, physical education specialist, nurse, kinesiologist and sociologist	Datos Health mobile phone app with multidisciplinary caregiver control center/ dashboard (technical details described in paper)	Home	Patient satisfaction and app use high. Significant improve-ment in exercise capacity, functional improve-ment, and consistent aerobic program adherence. Two-thirds achieved target minutes of exercise per week; one third achieved target intensity.
PATIENT PERCEPTION STUDIES
Source	Year	Country	Research aim	Research design [quality rating]	Sample size Age (mean, variance)	Sample Gender (male n; female n)	Sample primary Diagnosis/ Condition	Measures used in study*	Intervention (brief description)	Disciplines involved in intervention	Technologies used in delivery	Site where rehab received	Outcome
Alqahtani	2019	Saudi Arabia	To evaluate the knowledge, awareness, and perceptions of home health care patients regarding physiotherapy provided through telerehabilitation	Prospective observational cohort study CASP: Good	N=90 (males 65.8, +/ 9.4; females 58.7, +/ 7.8)	57 males; 33 females	Primary diagnosis of orthopedic problems requiring physical therapy with participant medical condition reported as orthopedic n=36; neurology n=24; sports n=15; other n=15	Telehealth Usability Questionnaire (TUQ) - translated to Arabic (awareness, knowledge, comfort); qualitative interview (on experience); interviews	Proprietary Telerehabilitat ion Technological Solutions service Telemedicine service consists of a portal to track health metrics and rehabilitation treatment plan and progress by the physical therapist, medical specialists as well as the Case Managers	Physical therapy professionals, case manager	The internet and video conferencing equipment installed at home and receiving services via video conference, including dealing with technical issues.	Home	All dimensions of the TUQ statistically improved after experience of telerehabilitation Awareness, knowledge, satisfaction increased after telerehabilitation experience
Bonnechere et al.	2017	Morocco	To evaluate the feasibility and acceptability of video games in ambulatory physical therapy.	Prospective observational cohort study CASP: Moderate	N=21 (mean reported 45 years; no variance reported)	7 males; 14 females	Tendinitis wrist/hand; Low back pain; ankylosing spondylitis, patella instability; foot fractures; balance problems; gait training; hemiparesis	Author-design questionnaire about video game exposure and access to Information technology; list of games used; extent of home use (habit); author designed survey on game acceptability; Bonnechere survey on home exercise translated to Arabic.	Physical therapy in ambulatory care with inclusion of video game instruction and use at home	Physical therapist	Mini games developed by authors for physical rehabilitation, exercise reminder using smart phone/email	Ambulatory physical therapy service department	Games were feasible in clinic setting, patients willing to try them at home, 19% afraid of falling during game, may help habit formation (only descriptive data presented)
Nabutovsky, Nachshon et al.	2020	Israel	Attitudes, perceptions, and behavioral intentions toward remote digital cardiac rehabilitation.	Cross sectional survey JBI: Good	N= 197 Mean age 64.8 years +/− 11.13 (20 to 91 years)	males; 139; 61 females	cardiac conditions	33 questions included Demographic characteristics; Lifestyle; Technological literacy and patterns of use of mobile phones, internet, computer, and monitoring devices.; Interest to receive health content through mobile phone; Interest to participate in a digital heart rehabilitation program and get telephone support	Recuperation hotel accommodati; on rehabilitation clinic - no telerehabilitati on - intervention this was exploring attritues towards potential use	No particular rehabilitation professionals identified - participant perspectives were about the use of telerehabilitation approach in general.	A range of approaches were identified and perspectives sought: cardiac-rehab telecounselling; remote digital cardiac rehab; cardiac rehab support via internet; exercise program by computer game; control over game configurations; virtual rehab class; physical activity monitoring	Rehabilitation center	Mobile phone: Text messaging was the most desired as well as email and video clips; internet; virtual reality for lifestyle managemen t, nutrition, physical activity, and mental wellbeing.
HEALTH PROFESSIONAL PERCEPTION STUDIES
Source	Year	Country	Research aim	Research design [quality rating]	Sample size Age (mean, variance)	Sample Gender (male n; female n)	Sample primary Diagnosis/ Condition	Measures used in study*	Intervention (brief description)	Disciplines involved in intervention	Technologie s used in delivery	Site where rehab received	Outcome
Aloyuni et al.	2020	Saudi Arabia	Nationwide survey of knowledge, attitudes towards, and perceived barriers to implementing telerehabilitation in physical therapy practice; including survey instrument development of these factors	Cross sectional survey JBI: Moderate	N=347 Age not reported	106 males; 70 females	N/A	Author- developed 14 item survey - demographic information, telerehabilitation knowledge, attitudes and barriers to telerehabilitation	No - intervention this was a survey of practitioner perspectives PTs reported utilizing telerehabilitation in assessment (17%), Diagnosis (3%), Prognosis (4%), intervention (6%), and follow-up 20%)	Physiotherapists only	While 79% used no telerehabilitation a minority used magebased telerehabilitation (10%) eg. Videoconferencing; sensorbased telerehabilitation (8%) eg tilt swtiches, acceleromet ers; virtual reality telerehabilitation (3%).	Hospitals and rehabilitation centers across 13 provinces in Saudi Arabia	have %58.8 knowledge about telerehabilitation; 31.7% reported their workplaces had equipment needed; main barriers; staff skills, technical issues and cost
Ullah et al.	2020	Saudi Arabia	Nationwide survey of Knowledge, attitudes towards implementing telerehabilitation and current practice	Cross section survey JBI: Moderate	N=82 Age not reported	52 males; 30 females	N/A	14 close-ended questions targeting five domains: demographics, telemedicine knowledge, telerehabilitation service knowledge, social acceptance of these services, and risks associated with these services	No - intervention this was a survey of practitioner perspectives	Physical medicine and rehabilitation (PM&R) physicians, orthotist/ prosthetist, physiotherapists, psychologists, occupational therapists, speechlanguage pathologists and rehabilitation nurses	Access to the following: smart phone/ simple phone	Primary, secondary, tertiary hospitals	Most participants think telerehabilitation is important, but most are not currently involved. There is a need for telerehabilitation guidelines and addressing the barriers pertaining to training, resources, cost, policy making, confidentiality, and perception of patients