Creatively Adapting Touch-Based Practices to the Web Format During the COVID-19 Pandemic: Systematic Review

Greta Gauhe, Rosamaria Kostic Cisneros, Jade Ward, David J Hohenschurz-Schmidt

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2 Citations (Scopus)
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The COVID-19 pandemic forced numerous touch-based fields, including manual therapy, body psychotherapy, arts therapy, creative arts practices, and the fitness industry, to swiftly transition to web-based service delivery. These disciplines faced substantial challenges in adapting their traditionally in-person practices, which rely heavily on physical touch and close proximity, to a web format.

This review intends to provide a systematically sourced overview of the literature concerning innovative approaches for adapting touch-based practices to the web format in response to the COVID-19 pandemic.

A systematic search across 7 databases and gray literature sources identified studies presenting innovative web delivery methods, particularly those addressing the challenges arising from the absence of physical proximity and touch. The inclusion criteria were designed to encompass studies exploring the creative adaptation of touch-based practices to web formats in response to the COVID-19 pandemic irrespective of study methodology. The exclusion criteria applied to studies focusing solely on technical aspects of web delivery or nontouch or noninteractive practices. There were no geographical restrictions, but the selection was limited to publications from 2020 onward. As only qualitative studies were found, data synthesis was conducted thematically.

The review encompassed 17 studies revealing that touch-based fields successfully devised innovative and creative methods for web service delivery. These methods were categorized into five main themes: (1) adapted working methods (cross-field methods), (2) adapted working methods for sensorial experiences and nonphysical connections, (3) creative methods using materials or additional tools, (4) creative use of web-based platform tools or additional technologies, and (5) creative methods requiring previous preparation of practitioners or participants. These creative approaches allowed practitioners to address the challenges of web touch-based practices, fostering connections and offering unique sensory experiences, albeit with some concerns related to technology and preparation.

These innovative methods demonstrate promise in circumventing the limitations imposed by the lack of physical touch and proximity in web settings during the COVID-19 pandemic. Furthermore, these insights hold potential for application in other fields in the future. This systematic search and thematic synthesis provide valuable guidance for practitioners and educators seeking to navigate the evolving landscape of web service delivery in touch-based disciplines, ensuring continuity of care even in challenging circumstances.
Original languageEnglish
Article numbere46355
Number of pages19
JournalJournal of Medical Internet Research
Early online date26 Oct 2023
Publication statusPublished - 26 Oct 2023

Bibliographical note

©Greta Gauhe, Rosemary E Kostic Cisneros, Jade Ward, David J Hohenschurz-Schmidt. Originally published in the Journal of Medical Internet Research (, 26.10.2023. This is an open-access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on, as well as this copyright and license information must be included.


DJH-S reports consulting fees from Altern Health Ltd. All other authors report no other conflicts of interest.


  • digital health
  • telehealth
  • eHealth
  • touch
  • creative arts
  • web
  • digital therapeutics
  • manual therapy
  • psychotherapy
  • arts therapy
  • qualitative study
  • web delivery
  • implementation
  • barrier
  • physiotherapist
  • psychotherapist


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