There's a version of telerehabilitation that nobody talks about much: the one that works. Not the hastily arranged video call, not the generic exercise sheet sent through a portal, but the session where a therapist has done the groundwork, understands the person on the other end of the screen, and has designed something worth the client's time. That version exists. And the research gives us a useful starting point for understanding why it matters.
What the Evidence Actually Shows
A 2024 study published in Healthcare surveyed 260 adults receiving allied health services from a large health district in Western Sydney — one of Australia’s most culturally and linguistically diverse regions. The researchers looked at three things: who had access to the technology needed for telerehabilitation, who was ready to use it, and who was willing to try it.
The numbers were telling. Around 72% of participants had access to technology, 38% met the readiness criteria, and 53% reported willingness to engage in telerehabilitation.
One of the study’s central questions was whether being from a culturally and linguistically diverse (CALD) background changed any of those figures. It didn’t. There were no differences in access, readiness, or willingness between patients from CALD and non-CALD backgrounds. The only factor that consistently shifted all three measures was age — and even then, the effect was gradual rather than absolute.
But the finding that carries the most weight for clinical practice sits elsewhere in the data. Participants who had past experience with telerehabilitation had 2.7 times higher odds of being willing to engage again, compared to those without prior experience. What that tells us is straightforward: a positive session doesn’t just help the person in front of you. It determines whether they’ll ever say yes again.
The Gap Between Access and Engagement
Having the technology doesn’t mean someone will use it for their rehabilitation — and this study makes that plain. Seventy-two percent of participants had access to a device. Only 38% were considered ready, and just over half were willing. The technology was there. The engagement wasn’t guaranteed.
This gap is where the quality of the clinician’s preparation matters most. It’s not enough to open a video call and run a standard protocol. The session has to be designed around the specific person — their home, their goals, their daily life, the things that matter enough to make the effort worthwhile.
That requires work before the session begins.
What Good Preparation Actually Looks Like
Understanding the person’s full picture. Their living situation, daily routine, what’s available to them at home, what they’ve tried before, and — importantly — what hasn’t worked and why. This is the foundation for making therapy relevant rather than generic.
Conversations with family members and caregivers. Families hold information that rarely surfaces in a clinical intake. They see the person across the whole day. They know what the person is genuinely struggling with, what they’re willing to say out loud in a clinical setting versus what they actually need, and what the real goals are. These conversations also surface practical barriers early — a shared device, a difficult home layout, a family member who travels for work — so they can be planned around rather than discovered mid-session.
A genuine understanding of wants and needs. A referral for balance rehabilitation after a fall tells you what happened. It doesn’t tell you what the person wants to get back to. That might be their weekly market trip, time on the floor with a grandchild, or the confidence to use the stairs without bracing. The goal that matters to the person is the one that will sustain their engagement across the whole course of therapy.
Therapist creativity and resourcefulness. Telerehabilitation requires a different kind of clinical thinking. What’s already in this person’s kitchen that could serve as equipment? What daily task or routine can carry therapeutic weight? How do you make an exercise feel like something rather than nothing? This is where good clinical reasoning meets genuine creativity — and it is not optional. It’s the difference between a session someone endures and one they actually benefit from.
Why the First Session Matters More Than People Realise
The study’s willingness data makes a strong case for getting the first session right. People who had previously experienced telerehabilitation were nearly three times more likely to be willing to do it again. That’s not a small effect. It means the first session — how it’s prepared, how it’s run, how well it connects to what the person actually cares about — sets the trajectory for everything that follows.
A session that feels like going through the motions doesn’t just fail the person in that moment. It closes a door. A session that’s genuinely useful, well-paced, and built around a meaningful goal opens one.
What This Means for Older Adults
Age was the only demographic factor that influenced access, readiness, and willingness to engage in telerehabilitation across all three measures. This isn’t a reason to treat older adults as a group that can’t participate — it’s a reason to provide better support around the technology itself.
That might mean a supported first session, a family member on the call, a lower-stakes introductory check-in before formal therapy begins. It might mean taking more time in the preparation phase to understand what the person is comfortable with and building from there. The goal is reducing friction, not assuming it can’t be overcome.
The researchers noted that the study’s findings add to growing evidence that the digital divide will widen as health services increasingly shift toward technology-based delivery — and that older adults are at greatest risk of being left behind without deliberate effort. Allied health teams have a direct role in closing that gap, one session at a time.
FAQ
Is telerehabilitation suitable for older adults? Yes. Older age does make access and readiness slightly less likely on average, but it’s not a fixed barrier. With the right preparation and practical support — including involving a family member in the session or running a supported first appointment — older adults engage effectively with telerehabilitation.
Does my cultural or language background affect whether telerehabilitation will work for me? No. Research shows that cultural and linguistic background does not predict whether someone is willing, ready, or able to engage in allied health telerehabilitation. What matters more is how the session is designed and what support is available.
What happens before my first telerehabilitation session? A well-prepared clinician gathers detailed background information about your daily life, home environment, and goals before the session. They may also speak with family members or caregivers. That preparation is what makes the difference between a session that’s relevant to your life and one that isn’t.
Do I need special equipment for telerehabilitation? Usually not. A smartphone, tablet, or computer with a camera and stable internet connection is sufficient. Your clinician will work with what you have available at home — that’s part of good session design.
Can family members join telerehabilitation sessions? Yes, and their involvement often improves outcomes. A family member or caregiver who understands the goals and the plan can provide meaningful support between appointments.
What if I’ve tried telerehabilitation before and didn’t find it helpful? One unsatisfying session doesn’t define what tele-rehabilitation can be. The research shows that positive past experiences significantly increase willingness to engage again — which also means that a poorly run session can put people off. If previous sessions felt like going through the motions, it’s worth raising that directly with any new provider.
Plan the best version of yourself with us
We are here to do it with you. As a progressive rehab therapy team, there are no case too big or small for us. What matters is to achieve quality – of life and outcomes. You can reach our team via WhatsApp for a no-obligation conversation about your situation, your goals, and how we can help.