Experiences of video-based and in-person initial consultations in individuals presenting with knee-related symptoms: A qualitative comparison

Video-based physiotherapy consultations are increasingly implemented within primary care, yet insight about patients’ subjective experiences remains limited. Prior research has primarily examined the reliability and validity of video-based physical assessments. However, a qualitative approach is useful while studying patients’ experiences of physiotherapy.
To explore and contrast patients’ experiences of initial physiotherapy consultations for individuals presenting with knee-related symptoms delivered via video or in-person in a primary care context.
A comparative qualitative study was conducted using individual, semi-structured interviews with 15 participants (8 in-person, 7 video-based). Data were analyzed using inductive qualitative content analysis. Separate analyses were conducted for each group, followed by a comparative thematic synthesis to identify converging and diverging experiences across consultation formats.
Participants with various knee-conditions were recruited from primary health care in both rural and urban areas. The analysis resulted in 5 categories and 19 subcategories. The categories were: Practical circumstances regarding the consultation, The need for communication and clear instructions, Video-based physiotherapy places new demands on the patient, Building a partnership, and Establishing confidence in the physiotherapy consultation.
In both in-person and digital settings, it is essential that physiotherapy is delivered in a way that fosters trust. Limited nonverbal communication in video-based consultations may hinder the development of trust and therapeutic alliance, shifting its foundation from interpersonal connection to perceived professional competence. Both consultation formats revealed a shared desire for more thorough examination, despite existing evidence supporting the adequacy of physiotherapy assessments. These findings suggest that video-based consultations are still perceived as a novel and evolving format, requiring time, experience, and clear communication to achieve broader acceptance.