The design process involved semi-structured interviews with the 22 participants, which were recorded and thematically analysed in order to refine the toolkit prototype. 

Participants suggested using infographics and video clips to provide information, adding additional treatment strategies and telehealth case studies targeted at new physiotherapy graduates.

After receiving this information, a large-scale baseline survey with 329 physiotherapists and physiotherapy students from 21 countries was conducted to examine the usability of the toolkit, looking at users’ perceived confidence, knowledge and competence relating to telehealth before they used the toolkit.

Baseline responses with the lowest agreement were ‘My perception is that patients value physiotherapy via telehealth the same as in-person care’ (13 per cent agreed or strongly agreed) and ‘For me, using telehealth to manage musculoskeletal conditions is as effective as in-person care’ (22 per cent agreed or strongly agreed).

Three months later at follow-up, toolkit users had greater improvement in knowledge, confidence and competence than non-users in 42 per cent of statements; 72 per cent of toolkit users said it changed their practice, while 95 per cent reported that they would recommend the toolkit to colleagues.

A strength of this study was the use of a co-design method to help physiotherapists create a toolkit that would be practical and relevant for them and their patients. 

Meanwhile, limitations included the unfeasibility of having a true control group for evaluation, as well as not being able to account for all influential external factors. 

In future, a randomised controlled trial could be useful.

Ezzat et al. Co-development and evaluation of the Musculoskeletal Telehealth Toolkit for physiotherapists. Musculoskeletal Care. 2024 (22:1) doi: 10.1002/msc.1840