Nine Japanese therapists described remote goal setting as a distinct practice, not a lesser one: they lost touch and whole-body observation but gained coaching roles, home visibility, and continuity as a goal. Structure remote sessions around what you cannot do, not just what you can.
All 9 therapists reported that the inability to physically touch clients and the reduced access to nonverbal and contextual information limited their confidence in understanding clients' conditions and priorities. They experienced this not as mere practical inconvenience but as a disruption to their professional certainty in clinical judgment.
Eight of the 9 therapists described shifting from direct hands-on intervention to a coaching role, using self-monitoring tools such as pedometers and check sheets, visual slide summaries, and family involvement to support goal setting between sessions. Several valued these adaptations not just as substitutes for in-person methods but as improvements in their own right.
Six of the 9 therapists described how sessions conducted in clients' own living environments made everyday needs more visible and clients more at ease, while a further 6 described reorienting rehabilitation goals away from functional improvement alone toward maintaining continuity, ongoing monitoring, and sustained therapeutic connection.
Single-blind randomized controlled trial. Sixty-four participants were randomized across two intervention arms and assessed at twelve weeks for the primary outcome…
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