Research, education and practice of tele-neurorehabilitation in low and middle-income countries: A Scoping Review

Article type: Review Article

Authors: Gandhi, Dorcas B.C.^{a; b; c; *} | Kamalakannan, Sureshkumar^d | Dsouza, Jennifer V.^e | Montanaro, Vinicius^f | Chawla, Nistara S.^g | Mahmood, Amreen^h | Ngeh, Etienneⁱ | Zarreen, Sania^j | Vijayanand, Pranay J.^j | Solomon, John M.^{g; k}

Affiliations: [a] Department of Neurology, Christian Medical College & Hospital Ludhiana, Ludhiana, India | [b] College of Physiotherapy, Christian Medical College & Hospital Ludhiana, Ludhiana, India | [c] Manipal Academy of Health Sciences, Manipal, India | [d] Department of Social Work, Education, and Community Wellbeing, Northumbria, UK | [e] Department of Physiotherapy, St. John’s Medical College, Bengaluru, India | [f] SARAH Network of Rehabilitation Hospitals, Brasília, Brazil | [g] Department of Physiotherapy, Manipal College of Health Professions (MAHE), Manipal, India | [h] Department of Health Professions, Manchester Metropolitan University, Manchester, UK | [i] Research Organization for Health Education and Rehabilitation-Cameroon (ROHER-CAM), Bamenda, Cameroon | [j] Department of Neurology, Christian Medical College & Hospital Ludhiana, Ludhiana, India | [k] Centre for Comprehensive Stroke Rehabilitation and Research, Manipal Academy of Higher Education, Manipal, India

Correspondence: [*] Address for correspondence: Dorcas B C Gandhi, Professor, College of Physiotherapy, Christian Medical College & Hospital, Ludhiana, Punjab 141008, India. E-mail: dorcas.gandhi@cmcludhiana.in.

Abstract: BACKGROUND:Tele-neurorehabilitation (TNR) allows for remote delivery of rehabilitation services for those with neurological disabilities. Despite growing global interest and uptake, its adoption remains challenging in Low-and-Middle-Income-Countries (LMICs). OBJECTIVE:To explore available literature on the nature of training and education, research and practice of TNR in LMICs. METHODS:Following PRISMA-ScR guidelines and predefined selection criteria, four databases were screened. Quality assessment was performed using the Joanna Briggs Institute tools. Relevant data was extracted to using a data extraction form in Microsoft Excel and were narratively synthesised under Education/training, Research and Clinical Practice of TNR. RESULTS:We identified no formal structured training courses/programs for TNR users/providers. Sessions were mainly delivered as part of a research project. The included studies highlighted the need to engage stakeholders in TNR research and improve digital-literacy among healthcare providers/users. Development and use of clinical decision-making-tools, models of TNR suitable for varied populations and prior area-mapping were a few suggestions for clinical/research practice. CONCLUSION:There is an immense need to develop academic/structured programs for TNR to build capacity among providers/users in LMICs. Practice must adhere to principles of safety, effectiveness, and based on high quality clinical-guidelines suitable to the context to ensure optimal uptake and practice of TNR in LMICs.

Keywords: Telerehabilitation, neurorehabilitation, low and middle income countries, research, education, practice

DOI: 10.3233/NRE-240053

Journal: NeuroRehabilitation, vol. Pre-press, no. Pre-press, pp. 1-15, 2024