China's Telerehabilitation Paradox: A National Survey on the Awareness-to-Practice Gap and Structural Barriers

Background Telerehabilitation is a key component of the global digital health transformation, offering a potent solution to health inequities, such as China's maldistribution of rehabilitation resources. However, its widespread adoption depends on professional acceptance, which is not well understood in the Chinese context. Objective This study aimed to investigate the utility, perceptions, contributing factors, and barriers regarding telerehabilitation among registered Chinese rehabilitation professionals. Methods A national cross-sectional web-based survey was conducted (n = 228) among registered rehabilitation therapists and physicians using a snowball sampling technique. The validated questionnaire assessed demographics, prior experience, perceived utility, preferred modalities, barriers, and attitudes. Data were analyzed using descriptive statistics, Chi-square tests, and Spearman's rank correlation. Results A significant "awareness-to-practice" gap was identified: while 67% were aware of telerehabilitation, only 23% had clinical experience with it. A majority (57%) held a neutral attitude towards its development. The primary perceived barrier was the constraint on "hands-on" techniques (75.4%). "Patient value" (68.4%), "policy" (55.3%), and "physiotherapist's expertise" (52.2%) were key implementation factors. Significant negative correlations were found between gender and attitudes (r=-.148, p = .025) and between working city-tier and perceived appropriate fees (r=-.211, p = .001). Conclusion Telerehabilitation in China is at a pivotal juncture, characterized by professional hesitancy rather than opposition. This "awareness-to-practice" gap is driven by a lack of standardized training, clear policy, and robust reimbursement structures. Addressing these structural, educational, and financial bottlenecks is imperative to unlock telerehabilitation's potential for improving healthcare accessibility and equity in China.