Musculoskeletal physiotherapists’ experiences of using remote consultations during the COVID-19 pandemic: A qualitative study

Background The COVID-19 pandemic resulted in the rapid implementation of remote consultations to maintain musculoskeletal physiotherapy services. However, little is known about UK musculoskeletal physiotherapists' experiences of providing services during the COVID-19 pandemic. Objectives To explore musculoskeletal physiotherapists’ experiences of using remote consultations in one area of England during the COVID-19 pandemic. Design Qualitative study using hermeneutic phenomenology based on the approach of Gadamer. Methods Semi-structured interviews with twelve musculoskeletal physiotherapists were conducted online using Microsoft Teams. Data were analysed using frameworks based on the philosophical concepts of Gadamer's hermeneutics. Findings Musculoskeletal physiotherapist's experience of using remote consultations during the COVID-19 pandemic were framed by three concepts: therapeutic relationship, transformational change, and uncertainty. These concepts are underpinned by four main themes capturing their experiences: (1) Disconnection: Difficulties building a rapport and reduced non-verbal communication affected building an effective therapeutic relationship, (2) Necessity: Transformation of services to remote consultations was positive, although technology and connectivity issues had a negative impact, (3) Loss of control: Diagnostic uncertainty, being unprepared, and experience affected physiotherapists' clinical practice, (4) Protection: Peer support and the use of technology facilitated a feeling of protection for physiotherapists. Conclusion The findings of this study contribute to a better understanding of musculoskeletal physiotherapists experience of using remote consultations during the COVID-19 pandemic. Implications for practice include the need to provide training for all musculoskeletal physiotherapists and undergraduates to enable the effective delivery of remote physiotherapy. Furthermore, digital infrastructure should be optimised to support future delivery of remote musculoskeletal physiotherapy services.