What Virtual Physical Therapy Can (and Can’t) Do: A Clinician’s Perspective
Updated September 2025 to include new data and insights
Musculoskeletal conditions are among the most expensive healthcare burdens in the U.S., with costs exceeding $380 billion annually, making them one of the largest categories of health-related spending.¹ At the same time, patient adherence to home exercise programs remains stubbornly low, with studies suggesting non-adherence rates between 50–65%.² These realities raise a pressing question: can virtual physical therapy (VPT) reduce costs, improve access, and strengthen patient engagement in ways that traditional models have struggled to achieve?
While virtual physical therapy has limitations, certain conditions are particularly well-suited for a digital approach. Patients focused on improving posture, functional strength, and balance can benefit from a skilled therapist guiding them virtually as they progress through their exercise programs. Those who are 6-8 weeks post-injury and no longer require hands-on treatment are also ideal candidates for virtual care. Companies like Sword Health, Kemtai, and Kaia Health are leveraging cutting-edge technology to provide personalized feedback. This feedback can improve adherence, which historically falls below 50% in unsupervised programs.³ Virtual care also eliminates the need for patients to commute, arrange childcare, or take time off work to attend in-person sessions. By removing access barriers and embedding real-time feedback, digital platforms may raise engagement levels closer to the 70–80% range seen in supervised programs, compared to far lower rates for unsupervised exercise.⁴ Meanwhile, clinicians benefit from a break from the constant demands of traditional outpatient clinic settings, allowing them to focus more on patient outcomes.
Several aspects of physical therapy lend themselves naturally to virtual care. Patient education, one of the most valuable tools in a physical therapist's toolbox, transitions seamlessly into a digital format. Therapists can provide essential information about healing timelines, the purpose of specific exercises, and expected recovery progress. Virtual platforms also offer the opportunity for therapists to spend more time educating patients on energy conservation techniques, pain neuroscience, and even nutrition. Furthermore, the ability to see inside a patient's home allows therapists to make personalized suggestions for modifying their living space to improve outcomes, such as repositioning furniture to encourage more movement or removing rugs to reduce fall risks.
This model also has the potential to alleviate some of the strain on an already overburdened healthcare workforce. By treating higher-functioning patients virtually, clinicians can free up time and resources in traditional clinic settings to focus on manual therapy, patients who require physical assistance, vestibular treatments, and more complex balance cases. Patients who require close monitoring for medical conditions or who have symptoms that may warrant a referral to another provider are not suitable candidates for virtual therapy.
Virtual physical therapy is more than a matter of convenience—it represents a chance to integrate data, technology, and clinical care in ways that expand access and improve efficiency. The key is measurement: Which metrics matter most? Adherence rates? Cost per episode? Patient-reported functional scores? As AI and digital health tools evolve, physical therapists are uniquely positioned not only to deliver care virtually but also to help define and analyze the data that determines what success truly looks like in this new landscape. Future research should continue to examine how these metrics vary across populations and health systems to ensure virtual PT achieves its full potential.
References
Dieleman JL, et al. U.S. Health Care Spending by Payer and Health Condition, 1996–2016. JAMA. 2020.
Jack K, et al. Barriers to Treatment Adherence in Physiotherapy Outpatients: A Systematic Review. Manual Therapy. 2010.
Correia FD, et al. Digital Rehabilitation for Low Back Pain: A Randomized Controlled Trial. JMIR. 2021.
Campbell R, et al. Adherence to Exercise Programs in Older Adults: Influences and Strategies. Australas J Ageing. 2014.
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