Why Canada Needs Online Physiotherapy.




Physiotherapists are regulated primary contact healthcare professionals, competent in a differential diagnosis model of assessments and triaging, evidence based treatment methods and designing safe, appropriate and progressive rehab exercise programs based on a patient’s medical profile, current condition and state of healing.   In addition, research conducted at the University of British Columbia into a physiotherapy triage model for orthopaedic surgery, found that experienced physiotherapists were four times better at identifying patients requiring surgery than emergency room physicians and family physicians (90% vs 22%) (1)

Despite access to physiotherapists in urban centers, 95% of the Canadian landmass is served by only 8% of all registered physiotherapists in Canada(2).

This means that there are thousands of Canadians – young and old –  living in rural areas without access to a local orthopaedic physiotherapist.

Unfortunately,  Canadians who receive delayed, inadequate or inappropriate treatment for an orthopaedic injury or condition are considered to be at a higher risk:

  1. To develop chronic neuromuscular pain,
  2. To become dependent on prescription pain medications,
  3. To develop permanent disability that prevents them from working or performing normal activities of daily living,
  4. To place a greater burden on families and other caregivers for support over their lifetime.
  5. To become increasingly dependent on the healthcare system over their lifetime.
  6. For patients who’ve undergone orthopaedic surgery and returned home without access to  a local physiotherapist, there is a greater possibility that they will not do their rehab properly or regularly,  will fail to meet their rehab goals on schedule and  potentially achieve a sub-par surgical outcome / result.




Developing  clinical pathways in healthcare is only as effective as the ability to deliver and implement them on the front lines. (right patient, right place, right time).

Faced with similar geographical issues, many countries around the world have adopted internet technology to  improve the implementation of clinical pathways  by bringing healthcare professionals directly into the homes of patients.

Online physiotherapy is not meant as a substitute for face-to-face care, however – for patients without easy access to a local physiotherapist;

  1. Online physiotherapy is considered better than receiving “no care” for their condition,
  2. Communicating with a physiotherapist  is helpful to interview, assess and ensure patients have been triaged onto the right clinical pathway for their condition,
  3. Physiotherapists are considered ‘movement’ experts in designing safe, appropriate and progressive rehab exercise programs based on a patient’s medical profile, condition and stage of healing.
  4. Communicating  with a  physiotherapist, is helpful to educate patients (and their families), answer questions and to identify warning signs of potential problems and complications.
  5. In the event the health and safety of a patient becomes an issue, a physiotherapist can communicate immediately with appropriate healthcare professionals to prevent and/or manage them.
  6. In the event a patient has undergone orthopaedic surgery and is behind schedule in their rehabilitation, a physiotherapist can communicate with  a surgeon to determine  most appropriate solution.

According to the  Canadian Alliance of Physiotherapy Regulators;

“Tele-rehabilitation technologies and applications are expanding rapidly and have the ability to improve patient access to care and otherwise increase efficiencies when used with the right patient at the right time. In some cases, such as when travel is difficult or there is no provider nearby, the use of the technology is preferable to a traditional (in-person) encounter.”(3)



  1. A physiotherapy triage service for orthopaedic surgery: an effective strategy for reducing wait times. Napier, C , McCormack RG,  Hunt, MA, Brooks-Hill A,  2013 Fall;65(4):358-63
  2.  Strengthening Rural Canada: Fewer and Older: Demographic and Population Challenges Across Rural Canada, A Pan-Canadian Report; CIHI Physiotherapist Data Tables 2015.
  3. Tele-rehabilitation in Physiotherapy Guidelines for Physiotherapists, Physiotherapy Alliance of Canada, Approved 170926.