Telerehabilitation - Historical Perspectives and Conceptual Framework in Reference to Neurological Disorders: A Narrative Review.
Paul Olowoyo, Rajinder K Dhamija, Mayowa O Owolabi
PMID 38995808WHAT IT FOUND
This review maps the history of telerehabilitation for neurological disorders, noting it began with speech therapy and now includes video, apps, and sensors.
It identifies barriers like poor digital literacy and limited physical exam options, but does not test whether these methods improve patient outcomes.
Key findings
01Telerehabilitation for neurological conditions has been studied most extensively for speech and language disorders, with more publications than for physical or occupational therapy applications.
02Key barriers to adopting teleneurorehabilitation include poor computer literacy, high anxiety about technology, and the difficulty of performing remote physical neurological examinations.
03While many reviewed studies reported high acceptability and efficacy, a Cochrane review found insufficient evidence to conclude telerehabilitation is effective for stroke due to a lack of randomised trials evaluating cost-effectiveness.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
This is a narrative and conceptual review, not a meta-analysis, so it does not provide pooled effect sizes or definitive evidence of efficacy. The search was limited to articles from 2004 to 2024, which may miss earlier foundational historical context. The review notes that many included studies were case reports or pilot programmes, which are lower in the hierarchy of evidence. The authors acknowledge that key stakeholders face significant barriers to adoption, such as poor computer literacy, which limits generalisability to all patient populations.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not interpret the high acceptability reported in these studies as proof of clinical effectiveness. The review explicitly states that a Cochrane analysis found insufficient evidence for stroke telerehabilitation effectiveness due to a lack of randomised cost-effectiveness trials.