Barriers and Challenges of Implementing Telerehabilitation: A Systematic Review

Objectives: Telerehabilitation (TR) is an alternative approach for providing rehabilitation services in some situations, like Coronavirus Disease ۲۰۱۹ (COVID-۱۹) pandemic. There exist some obstacles, especially during the pre-implementation phase of TR, necessitating an investigation of existing local evidence. This research aimed to investigate the challenges of TR. Methods: Five electronic databases (Scopus, PubMed, Google Scholar, SID, & Magiran) were searched for studies published in English and Persian language from ۲۰۱۱ to February ۲۰۲۱. Search results in all databases provided a total of ۵۹۸ articles. After reviewing the titles of the articles, we excluded ۵۷۴ articles as they were duplicated and/or irrelevant. Finally, based on the inclusion and exclusion criteria, ۱۱ articles have remained. Results: Most extracted articles were published in ۲۰۲۰ (n=۴). The remaining articles disturbed between ۲۰۱۳ until ۲۰۲۱. These articles were mostly reviews, case reports/series, or qualitative studies and surveys. Geographically, ۲۷% of the final selected papers belonged to the USA, ۴۶% to Asia, and ۲۷% to Europe. Outcomes in studies mostly included TR advantages and disadvantages, facilitators, challenges, and barriers. Discussion: Studies specified numerous challenges for TR implementation. The main challenges in the technologies used in TR were the awareness and culture of individuals and the TR infrastructure. Despite these barriers, TR could be a better treatment selection in some patients. Therefore, it is necessary for health policymakers, and especially rehabilitation managers, technology developers, scientists, and clinicians to cooperatively make serious efforts to remove these barriers.

Keywords:

Barriers , Challenges , Obstacles , Telerehabilitation , Telemedicine