Acceptability of Telehealth Physical Therapy in Adults with Chronic Low Back Pain: A Multivariable Analysis of Knowledge, Attitudes, Barriers, and Biopsychosocial Health Factors.

Background

Telehealth acceptance for chronic low back pain (CLBP) remains unclear. It may depend on patients' knowledge, attitudes, barriers, and health factors. This study assessed telehealth physical therapy's acceptability for CLBP by examining willingness, knowledge, attitudes, and barriers, and comparing willingness among healthcare professionals.

Methods

This study included 309 adults with CLBP. The Telemedicine Perception Questionnaire (TMPQ) assesses perceptions and barriers. Participants rated telehealth willingness and completed the PROMIS-29 for health factors. The descriptive statistics summarized the characteristics. The Friedman test was used to compare professional willingness, t-tests were used to examine sex differences, Pearson's correlation was used to assess PROMIS-29 and telehealth willingness, and multivariate regression was used to identify the related variables.

Results

The participants had an average age of 26.06 years, and 90% were female. Willingness varied (p < 0.001), being highest among dietitians (3.86 ± 1.15), lowest in physical therapists (3.52 ± 1.13). Males reported more telehealth barriers (p = 0.043), and females had higher anxiety, depression, fatigue, and pain scores (p < 0.05). Willingness to use telehealth physical therapy correlated with physical function (r = 0.319). The knowledge score was most strongly correlated with physical function (r = 0.368). Regression analysis showed that knowledge (B = 0.057, p = 0.011) and attitude (B = 0.063, p < 0.001) predicted greater telehealth willingness, with the model explaining moderate proportion of the variance in willingness to use telehealth physical therapy (R2 = 0.381; adjusted R2 = 0.370).

Conclusions

Telehealth physical therapy was moderately acceptable in adults with CLBP. Knowledge and acceptance increased the willingness to use telehealth services. Higher knowledge of telehealth and more positive attitudes were associated with a greater willingness to use telehealth physical therapy. These findings suggest that patient education and clear orientation to telehealth procedures may support readiness for telehealth-based physical therapy. However, the strong predominance of female participants (90%) and the self-selected online sample should be considered when interpreting the findings, as these factors may limit generalizability to the broader CLBP population.