Scope, context and quality of telerehabilitation guidelines for physical disabilities: a scoping review

Abstract

ObjectiveTo identify the available guidance and training to implement telerehabilitation movement assessments for people (adults and children) with a physical disability, including those recovering from COVID-19.DesignRapid scoping review.Included sources and articlesPubMed, CINAHL, PsychInfo, Cochrane, Embase, Web of Science, PEDro, UK Health Forum, WHO, National Archives and NHS England were searched using the participant–concept–context framework from 2015 to August 2020. Primary studies that recruited individuals with physical disabilities and guidance documents aimed at providers to implement movement-related telerehabilitation were included.Results23 articles (11 primary research studies, 3 systematic reviews and 9 guidance documents) were included out of 7857 that were identified from the literature search. Two main issues were found: (1) telerehabilitation guidance (from both research studies and guidance documents) was not specific to movement-related assessment and (2) most primary research studies provided neither guidance nor training of movement-specific assessment to practitioners. Of the COVID-19 related guidance, two articles reported COVID-19 management that only referred to identifying COVID-19 status without references to specific movement-related guidance.ConclusionsTelerehabilitation guidance and training have existed pre-COVID-19, yet the lack of specific movement-related information and provider support is surprising. This gap must be addressed to optimise effective implementation of remote assessments for those with physical disabilities.Review registrationOpen Science Framework: osf.io/vm6sp.

Providers' Shift to Telerehabilitation at the U.S. Veterans Health Administration During COVID-19: Practical Applications

“…Moreover, findings include information specific to movement considerations and safety considerations for patients with physical disabilities or impairments impacting cognitive functioning. A 2021 scoping review of telerehabilitation guidelines regarding patients with physical disabilities found only three studies providing specific provider guidance; however, the guidance was specific to use of the telerehabilitation technology (42). These researchers concluded a notable lack of movement-specific related clinical telerehabilitation guidance.…”

Using Telehealth to Guarantee the Continuity of Rehabilitation during the COVID-19 Pandemic: A Systematic Review

“…Telerehabilitation could indeed complement the current rehabilitation services, allowing healthcare professionals to support and treat patients in remote locations using telecommunications technology, guaranteeing people access to medical expertise in a quick, flexible and efficient manner, without having to travel, resulting in less burden and great satisfaction. However, the current level of evidence supporting this kind of intervention in clinical practice is still relatively limited [ 14 ]. Considering that the actual extent of the implementation of telerehabilitation during the current COVID-19 pandemic is still unclear, this review aims to summarize and analyze the different solutions that have been proposed to remotely support patients with a variety of health conditions in their rehabilitation process during the COVID-19 pandemic, highlighting the effectiveness and feasibility of such interventions.…”

Telerehabilitation for physical disabilities and movement impairment: A service evaluation in South West England

“…The findings from this service evaluation have been collated and triangulated with our scoping review 5 and survey 9 to inform the content of the Telerehab Toolkit (http://www.plymouth.ac.uk/research/telerehab). 10 The Toolkit was developed iteratively using the KTA framework, 13 and provides information and guidance for practitioners and patients, with a focus on telerehabilitation for people with physical disabilities and movement impairment.…”

“…Digital inclusion has been recognized as an essential component for planning and evaluating remote consultation services in a new framework developed by Greenhalgh et al 24 The challenges of telerehabilitation identified in this service evaluation were in line with those recognized in our survey 9 and previous studies. 5 The challenges most frequently discussed by practitioners and patients were: technical issues (usability problems with hardware and software, difficulties accessing technology and a lack of digital skills); difficulty seeing or hearing patients; concerns about the lack of 'hands-on' care; and safety concerns. Technical issues, experienced by both practitioners and patients, are a frequently reported barrier to telerehabilitation.…”

“…This speed of implementation has resulted in a dearth of guidance and training for practitioners. Although learning needs for healthcare professionals in using video consultations have been previously identified, 4 there was little specific published guidance, training and support on how to undertake assessments and deliver rehabilitation remotely for people with physical disabilities 5 . Professional bodies and clinical networks have highlighted the marked variations in approaches to telerehabilitation between and even within organisations, expressing concerns about potential inequity and inefficiency 6–8 .…”