Telerehabilitation for individuals with spinal cord injury in low-and middle-income countries: a systematic review of the literature

Spinal Cord, 2022 · DOI: https://doi.org/10.1038/s41393-022-00797-8 · Published: April 11, 2022

Spinal Cord Injury Telehealth & Digital Health Public Health

Simple Explanation

This review looks at whether telerehabilitation (rehabilitation at a distance using technology) is effective for people with spinal cord injuries (SCI) in low- and middle-income countries (LMICs). The review found some evidence that telerehabilitation may improve quality of life and pressure ulcer management, and may also improve functional ability and depression scores. However, the authors concluded that there is not enough evidence to recommend telerehabilitation as a standard treatment for SCI in LMICs, and more research is needed.

Study Duration

Not specified

Participants

Five studies included, sample sizes ranged from 2 to 410

Evidence Level

Systematic review, GRADE scores varied from very low to moderate

Key Findings

1
Some significant improvements to quality of life and pressure ulcer management were observed with telerehabilitation.
2
Telerehabilitation alleviated participants’ sense of social isolation, improved satisfaction scores and assisted them to remember techniques for SCI management.
3
There was no reduction in all-cause mortality with telerehabilitation in the studies reviewed.

Research Summary

This systematic review evaluated existing literature about the effectiveness of telerehabilitation as an intervention for the management of SCI, focusing on LMICs. Of the five included studies, there is some suggestion that telerehabilitation improves the lives of those with SCI in LMICs. Limited literature is available reporting the use and effectiveness of telerehabilitation as an intervention for SCI in LMICs.

Practical Implications

Policy Development

Efforts to improve policy and develop rehabilitation care are necessary in LMICs to support telerehabilitation implementation.

Healthcare System Strengthening

Telerehabilitation should enhance existing good-quality care, not replace it. Vital local services and rehabilitation care must be adequate and available for individuals with SCI to benefit.

Further Research

There is a need to establish a set of outcomes for the investigation of telerehabilitation and better define causal mechanisms underpinning positive and negative findings.

Study Limitations

1
Due to time and resource constraints, the review was unable to search grey literature sources.
2
The studies were heterogenous in terms of their design and outcomes used, making comparison difficult.
3
Largely absent from the literature are considerations of cost relating to telerehabilitation in LMICs.

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