Current Status of Telerehabilitation Services in Low-Middle Income Countries - A Scoping Review

Area of Science:

• Health Sciences
• Rehabilitation Medicine
• Digital Health

Background:

• The COVID-19 pandemic accelerated telerehabilitation adoption in low- and middle-income countries (LMICs), leading to numerous telehealth initiatives.
• Many of these telehealth initiatives in LMICs remain unexplored, necessitating a comprehensive review of their current status and challenges.

Purpose of the Study:

• To assess the current state of telerehabilitation services in LMICs across Asia and Africa.
• To identify key themes including implementation challenges, user perceptions, and legal-ethical aspects of telerehabilitation in LMICs.

Main Methods:

• A scoping review was conducted using Arksey and O'Malley's five-stage framework and PRISMA-ScR guidelines.
• Two review periods were utilized: 2012–2022 and 2023–January 2025, analyzing a total of 87 relevant articles.

Main Results:

• Users reported positive experiences with telerehabilitation, primarily through mobile phones and video conferences, despite limited ICT skills and infrastructure.
• Key themes identified include telerehabilitation status, pandemic utilization, implementation challenges, user understanding and perceptions, feasibility, and legal-ethical considerations.
• Privacy concerns and digital literacy issues were noted as significant challenges for users.

Conclusions:

• Formal policies and sustainable implementation strategies are lacking in many LMICs, despite WHO guideline adoption and donor support.
• Context-specific and sustainable frameworks are crucial for strengthening telerehabilitation services in LMICs.
• Addressing digital literacy and privacy concerns is essential for improving telerehabilitation accessibility and effectiveness in these regions.