Use and Perceptions of Teletherapy Among Physiotherapists in Germany: Descriptive Cross-Sectional Online Survey

Abstract Background Teletherapy is gaining increasing importance in physiotherapeutic care but has so far been only marginally established in Germany. The current state of use, attitudes, and perceived barriers among physiotherapists remains insufficiently described. Objective This online survey aimed to assess perceived barriers, enabling factors, and competence-related needs for the implementation and use of physiotherapeutic teletherapy among participating physiotherapists in Germany. Methods A descriptive cross-sectional online survey was conducted among practicing physiotherapists in Germany using the LimeSurvey platform between March 7 and May 21, 2025. Participants were recruited through an open convenience sampling strategy via physiotherapy-related social media channels, university alumni mailing lists, the mailing list of the German Association for Musculoskeletal Therapy, and an article on physio.de; all individuals with access to the survey link were able to participate. The questionnaire collected demographic and professional data as well as information on current and intended use of teletherapy, perceived barriers and benefits, training needs, and self-assessed competence to deliver teletherapy. Data were analyzed descriptively. Results A total of 761 individuals started the survey, of whom 458 completed the questionnaire in full and were included in the analysis. In this sample, 30 participants reported prior experience with teletherapy. Most participants considered teletherapy meaningful for future physiotherapy care, but only a minority felt sufficiently informed about its use. Frequently reported barriers included integration into daily practice routines, insufficient information on legal and organizational frameworks, and insufficient digital infrastructure within practices. Participants most frequently identified further training, exchange and support from colleagues, and information from professional associations and health insurance providers as potential facilitators. Exploratory descriptive stratified analyses suggested that participants with prior teletherapy experience more often felt sufficiently informed and competent and reported selected implementation barriers less frequently than participants without prior experience. Conclusions In this sample, physiotherapeutic teletherapy was rarely used but was widely perceived as meaningful for future care. Participants reported structural, organizational, informational, and competence-related barriers that may limit routine implementation. These findings suggest that clearer guidance, targeted training, and implementation support from professional associations, health insurance providers, and educational institutions may help physiotherapists integrate teletherapy into practice where clinically appropriate.