Research, education and practice of tele-neurorehabilitation in low and middle-income countries: a scoping review

Gandhi, Dorcas BC, Kamalakannan, Sureshkumar, Dsouza, Jennifer V, Montanaro, Vinicius, Chawla, Nistara S, Mahmood, Amreen ORCID: https://orcid.org/0000-0002-2803-3598, Ngeh, Etienne, Zarreen, Sania, Vijayanand, Pranay J and Solomon, John M (2024) Research, education and practice of tele-neurorehabilitation in low and middle-income countries: a scoping review. NeuroRehabilitation. pp. 1-15. ISSN 1053-8135

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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.