Table 4 Summary of themes, subthemes and supporting quotes

Empowerment

Problem solving ways to complete the exercise

“I did on a position on the steps to the back deck, where I was looking straight at a glass door, so it was the same effect as having a mirror. I could see how high I was lifting my knee and all of that sort of thing.” (Client (C) C7)

“What I did was I just kind of incorporated them into my day” (C9)

“Well I’ve set up obstacles out on the veranda, so I’ve got a reasonably long veranda going onto a footpath …… And then I set up the doggy trampoline at the back wall and used the ball to throw against the wall.” (C1)

“But you just improvise, and the other thing is just to vary it a bit, sometimes you do it a little bit differently. But still trying to concentrate on the core part of the exercise, which in that case might be balance or stretching out or something like that.” (C13)

Developing self-monitoring strategies

“I really like to have a fairly detailed recording sheet, so that I can compare my progress.” (C5)

“My friend has actually given me her Fitbit. So that’s quite good too, because you think if I get on the treadmill, I can actually see how many steps I’m doing,…….. So that’s been motivating, to just help with doing that exercise.” (C5)

Value of feedback

Feedback provided via telephone calls was limited

“I think I’m doing it right; I’m never entirely 100 percent sure that I am, of course, because there’s no one there telling me that that’s right or not right.” (C3)

“….then you saw them face-to-face and thought, you’re doing something completely different to what I thought you were doing.” (Student (S)7)

“I guess that’s the other thing that’s hard over telehealth is like, like self-reported exercise, it’s really difficult to know what they’re actually doing and whether they’re doing it correctly even though they think they are.” (S6)

Video calls enabled feedback on performance of the exercises

“…kind of the video calls, when you see people doing it you realise how much more feedback you can give when you actually see it.” (S4)

“think the video calls were really great because, and we got to see what people were actually doing and give them some specific feedback, which was really helpful for them.” (S7)

“But then when we went to video later on, it was so much easier because you could demonstrate with the video, what you’re talking about. That was… so I found that the video was terrific.” (C8)

“In a sense it didn’t feel any different from being assessed at the clinic or something like that. Somebody was watching you do the exercises.” (C7)

Mode of delivery

Regular contact via telephone calls

“I think that worked really well because the video calls were kind of a bit of a hassle to set up and that kind of thing, whereas the phone calls made it really accessible, but the videos gave you greater information and allowed you to do more with your clients.” (S7)

“I’ve actually found it pretty useful, mainly because the phone call every week tends to keep me honest about what I’m doing, and I don’t want to tell too many fibs about it.” (C3)

“Having that phone call each week was really motivating. Because you’d get halfway through the week and go oops, I haven’t been doing what I’m supposed to do. Oops, they’re going to ask me, so you sort of had that guilt.” (C5)

“So that’s why I think I stopped the phone calls, because I thought, it’s getting me nowhere and I’ll wait until the Hub (i.e., classes) starts up again. But then I thought to myself, I’m not doing the exercises, and that’s why, I thought I’m wasting their time and mine.” (C6)

“I wasn’t looking forward to those phone calls. ……… And sometimes they were half an hour later, right, so I’m hanging around, I can’t go outside, I can’t do this, I can’t do that.” (C1)

Using video calls

“A bit daunting to begin with, because I hadn’t done it before, hadn’t set it up, logged in, and it just worried me, something would go wrong. Once I got in to do it, it was fairly straightforward.” (C8)

“So, it shows that people, if they can … if we can teach them a system, they’re pretty good at learning that technology.” (S2)

“The video compared to the phone was a lot more technologically challenging for us and the clients …… It’s a lot more time consuming, especially video calling.” (S4)

Therapeutic relationships

Maintaining relationships

“So we sort of interspersed it with a little bit of conversation and I think that’s really important that the students don’t mind doing that. I know it’s a phone call and it’s a very specific phone call they’re making, but all those little bits actually help to build that relationship.” (C5)

“The students were all very good, very friendly and genuinely interested in what you were doing.” (C7)

Challenges of building relationships via telephone calls

“…. you had the phone call and you’re just answering the questions that they ask you, you can’t see the person, so you miss the interaction that you have.” (C10)

“So some people would be like, “oh, [student name] you’re back again.” And then other people would just have no idea that I was the same person that had called them like beforehand.” (S6)

“And with changing the students, that was difficult. So when we first started off it was [student name] on the phone, and because we’d worked with [student name] I knew the person. Right. It was very difficult to get a new student, and sometimes the student wasn’t exactly sure just how to approach over the phone.” (C1)