Indian physiotherapists support telerehabilitation, but protocol readiness remains thin
Cardiac and pulmonary telerehabilitation may be an obvious way to widen access to rehabilitation, yet the clinical workforce expected to deliver it is still catching up. In a cross-sectional survey of Indian physiotherapists, awareness and enthusiasm for telerehabilitation were clearly present, but formal preparation for routine use lagged behind the optimism. The gap is important because cardiopulmonary rehabilitation depends on structured exercise prescription, monitoring, and patient coaching; without a consistent framework, remote delivery can easily drift from supervised therapy into improvised advice.
The study used a validated 29-item questionnaire to assess knowledge, attitude, and perception among 121 physiotherapists in India. Most participants were MPT-qualified and had 2 to 7 years of experience, a background that suggests the respondents were not novices entering the field but practitioners already embedded in clinical care. Even with that level of training, only 34.7% were aware of standardized protocols for telerehabilitation.
Awareness was broad, but operational knowledge was uneven
A striking 72.7% of respondents demonstrated essential understanding to implement a cardiopulmonary telerehabilitation program. That figure points to a workforce that recognizes the model, its goals, and its place in care delivery. Yet knowledge at the level of execution was far weaker. Protocol awareness is the difference between knowing a service exists and knowing how to run it safely, particularly when patients have heart failure, chronic lung disease, exercise intolerance, or unstable symptoms that demand careful triage.
This split between general understanding and procedural readiness matters in rehabilitation medicine. Cardiorespiratory therapy is not a passive consultation service; it relies on progression rules, symptom surveillance, emergency escalation pathways, and documented criteria for modifying exercise. When fewer than four in ten clinicians know standardized protocols, implementation risk is no longer theoretical. It becomes a question of whether a program can be delivered with enough consistency to protect patients and reproduce outcomes across settings.
Confidence was high, but training demand was almost universal
More than half of the physiotherapists, 56.2%, believed they could implement telerehabilitation safely and effectively. A larger proportion, 63.6%, were willing to include it in regular practice. Both figures suggest real clinical interest rather than skepticism toward remote care. Even so, 99.2% said training was needed before implementation, which is about as clear a signal as a survey can produce.
That near-unanimous demand for training reveals where the bottleneck sits. The issue is not rejection of the model; it is the absence of a clear implementation pathway. In a field where exercise intensity, oxygen saturation, dyspnea, fatigue, and patient adherence all influence outcomes, clinicians are asking for the tools to translate principle into practice. A remote platform can extend access, but it cannot substitute for competence in assessment, monitoring, and escalation.
Perceived patient benefit may help adoption if systems catch up
The perception data were especially encouraging. Nearly all respondents, 95.9%, believed the model could make significant differences in patients’ quality of life. Meanwhile, 78.5% felt it could be as effective as a center-based rehabilitation program. Those beliefs matter because clinician buy-in often determines whether a service survives beyond the pilot phase. If physiotherapists view remote rehabilitation as clinically worthwhile, the remaining barriers are more likely to be structural than attitudinal.
Still, belief in benefit is not the same as readiness to deliver care. Telerehabilitation can reduce common barriers in middle- and low-income settings, including travel burden, appointment attrition, and the scarcity of rehabilitation centers. For patients with cardiopulmonary disease, those barriers are not minor inconveniences. They often determine whether rehabilitation is started at all. Remote delivery has the potential to close that access gap, but only when training, protocols, and workflow support are in place.
The Indian rehabilitation workforce is ready for scale, not yet for standardization
The data point toward a workforce at an early implementation stage. Physiotherapists appear willing to adopt cardiac telerehabilitation and pulmonary telerehabilitation, and most already recognize the potential clinical value. What remains incomplete is standardization: standardized protocols, practical training, and confidence in real-world delivery across diverse patient groups.
For India, that sequence is especially relevant. Telerehabilitation is comparatively new in this setting, and new models often fail not because clinicians reject them but because they are introduced without enough operational support. Rehabilitation programs require more than internet access and a video platform. They need triage rules, exercise prescriptions tailored to disease severity, emergency planning, patient education scripts, and a way to document adherence and response. Without those elements, clinicians may remain positive in principle while hesitating in practice.
The findings also carry a broader message for health systems planning remote rehabilitation services. Positive perception can create momentum, but training converts momentum into usable care. In this survey, the demand for preparation was overwhelming, and the awareness of standard protocols was conspicuously limited. Those two facts sit side by side and define the implementation challenge more clearly than any abstract argument about digital health ever could.
Training, not enthusiasm, is the limiting step
If telerehabilitation is to move from concept to routine cardiopulmonary care, the next step is not persuasion. It is education.
The survey offers no direct outcome data on patient health, adherence, or service quality, so it cannot prove that remote rehabilitation works better or worse in Indian practice. It does show where clinicians stand before widespread adoption: supportive, interested, and underprepared for standardized deployment. That is a practical starting point for curriculum design, professional training, and future implementation studies that examine whether protocol-based instruction changes real clinical behavior.