How telerehabilitation has been carried out across countries at different economic levels during COVID-19 pandemic? A scoping review. (Preprint)

Abstract

Background: One of the consequences of the COVID-19 pandemic for health services worldwide is the need to provide healthcare remotely to provide assistance with social distance. Strategies involving telerehabilitation have been applied, however, the provision of this service may vary between countries with different socioeconomic levels, being considered a challenge.

This scope review aimed to summarize the telerehabilitation experiences for physical therapy during the COVID-19 pandemic in countries with different economic levels.

METHOD: A scope review was carried out, using the guidance for scope reviews in the Joanna Briggs Institute manual and the methodological framework proposed by Arksey and O'Malley. The review protocol was registered at the Open Science Framework. We included studies published after the World Health Organization announced the outbreak of COVID-19 as a pandemic (March 11, 2020) in which included patients of any age undergoing telerehabilitation for physical therapy assistance. The search strategy was carried out in three stages in the databases MEDLINE, CINAHL, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, PEDro and Web of Science.

RESULTSː The search found 230 studies. After full text screening, 13 were included and had their data extracted for analysis. All studies were published in English language, from April to September 2020. Most of the articles were originally from high-income countries. Only one study was developed in a high middle income country and another one of low middle income country. The types of studies and approaches to telerehabilitation varied among studies and the target population included the older people, individuals with functional limitations, children and hospitalized patients.

CONCLUSIONS: Although the COVID-19 pandemic has increased the discussion on this topic, there are marked differences in the number of studies on telerehabilitation in countries with different economic levels. Higher income countries, which already practiced telerehabilitation, had their services expanded, while not higher income countries are still incipient in this approach. Factors such as internet access, infrastructure, professional adherence and digital literacy remain barriers to the equal use of this tool.