Global demand for rehabilitation services is increasing, yet access remains constrained, with low- to middle-income countries facing disproportionate barriers. Telerehabilitation offers a promising solution, but successful implementation depends on understanding user perspectives and acceptance.
This scoping review aims to synthesise patient, caregiver and family member perceptions and experiences regarding technology-delivered rehabilitation services and identify implications for improving service delivery through this modality.
Studies examining telerehabilitation interventions across various healthcare contexts published between 2000 and 2024.
A complete search of the literature will be conducted across four databases (PubMed, Web of Science, Scopus and EBSCOhost) supplemented by grey literature sources including theses, opinion pieces, scholarly articles and organisational reports. Two reviewers will independently examine titles, abstracts and full texts of English and Afrikaans publications reporting qualitative information on perspectives and experiences of patients who received telerehabilitation or their family members/caregivers.
The scoping review will summarise current evidence on user experiences with telerehabilitation, identifying key themes, barriers, facilitators and recommendations.
This review will provide valuable insights into stakeholder experiences with telerehabilitation to inform future implementation.
Findings will guide the development of patient-centred telerehabilitation programmes and identify research gaps to enhance technology-enabled rehabilitation service delivery worldwide.
Rehabilitation services are experiencing an increased demand globally (World Health Organization [WHO]
Rehabilitation is traditionally delivered using a face-to-face model. This mode of delivery is seen to be beneficial as it provides direct patient-therapist interaction with hands-on manual techniques, hands-on assessment and immediate feedback (Muñoz-Tomás et al.
The application of technology in healthcare is increasing (Srivastava et al.
Telerehabilitation offers numerous person-centred benefits (Cranen et al.
User perspectives about the use of technology in healthcare are mixed. Published reports, mostly biased towards high-income settings, suggest that some patients may be sceptical about the use of technology for rehabilitation delivery (Ariza-Vega et al.
To our knowledge, there are no qualitative systematic syntheses to explore patient and caregiver perspectives, preferences and concerns about telerehabilitation as a mode of delivery. Understanding the patient perspective is crucial for optimal health system and patient outcomes. Therefore, this study aims to systematically synthesise patient, caregiver and family members’ perceptions and experiences with telerehabilitation. A specific focus will be on identifying barriers and facilitators to adopting telerehabilitation, describing perceived outcomes related to telerehabilitation, including patient satisfaction, experience, adherence and engagement and identifying research gaps and practice implications for telerehabilitation based on insights from these groups. Through this patient-focused lens, the research seeks to inform the development of optimised, tailored telerehabilitation programmes and identify implications for improving accessibility and quality of rehabilitation care.
Studies will be included that explore all patients attending or attended rehabilitation services at healthcare settings. Rehabilitation services will consist of the following services: physiotherapy, occupational therapy, speech, language and hearing therapy, orthotists, prosthetists, clinical psychologists, physical medicine and rehabilitation doctors, and rehabilitation nurses (WHO
Studies will be considered for this scoping review that focus on the experiences and perspectives of telerehabilitation use (information on technology use in rehabilitation) during rehabilitation services by patients and their caregivers. The studies will also include the implementation of telerehabilitation in healthcare services at all levels of care where rehabilitation services are provided.
Publications will be included in this scoping review that are based at any healthcare facilities where rehabilitation services are provided, including, but not limited to, hospitals, primary care facilities, residential care homes and rehabilitation facilities.
This review will include original studies that use qualitative methodologies. Studies must be in English and Afrikaans and in the date range of 2000 to 2024. This review omitted studies published before 2000. Telerehabilitation is a relatively modern field, and technology, along with methodologies, has advanced rapidly in recent years. Including studies before 2000 may not accurately represent the current state of telerehabilitation or reflect the latest technological and methodological advancements. Moreover, excluding pre-2000 studies allows the review to concentrate on the most recent and relevant literature, thereby enhancing the review’s quality and relevance.
The methodology draws on the JBI framework for scoping reviews (Aromataris & Munn
PubMed (MEDLINE) was searched initially to check for existing reviews (
All identified records will be compiled and transferred to Rayyan (systematic review and meta-analysis software tool) following the search (Ouzzani et al.
A Microsoft® Excel form developed by the research team will be used for independent data extraction by two reviewers. This form will be based on the JBI-QARI (qualitative data extraction tool for qualitative research) (Munn, Tufanaru & Aromataris
Thematic analysis will help identify main themes and sub-themes from the included articles (Creswell
As of September 2024, the current review is at the data extraction phase. Following the above analysis, results from included studies will be reported narratively. The collated results will be incorporated into a manuscript. The complete article will be submitted to a peer-reviewed open-access journal for publication. The outcomes of this scoping review are anticipated to be ready for submission by July 2025. The data gathered through this scoping review will be made accessible upon reasonable request.
The proposed protocol will provide a guide on conducting the scoping review to map existing studies on the perspectives and experiences of patients, carers and family members on the use of technology in rehabilitation. The growing demand for rehabilitation services, especially for LMICs (WHO
A limitation of our scoping review is the exclusion of studies published before 2000, which may omit relevant historical perspectives on the evolution of telerehabilitation. A scoping review was selected for this study as the aim of the study is to provide a broad overview of the perspectives of the patients and their caregivers using TR. Therefore, this fits the methodology of a scoping review better. A systematic review will limit the data available for inclusion. Additionally, the review scope includes English and Afrikaans publications only, potentially overlooking valuable insights from non-English and Afrikaans-speaking populations. The full search of all databases was conducted with no limitation on languages. Languages were only limited by the final search. Approximately 650 searches were found before the limitation was added. Only 2 of the overall searches were in another language, namely Spanish (Coronel et al.
This scoping review will examine patient, caregiver, and family member perspectives on TR services. The review will analyse qualitative studies published from 2000 to 2024 to identify barriers, facilitators, and user experiences with TR. The findings will contribute to the development of patient-centred TR programmes and provide evidence to guide implementation strategies for improving access to rehabilitation care. Understanding user perspectives is essential for the successful adoption of TR services in healthcare systems.
The authors would like to thank Dr Marisa Coetzee, Ms Thandi Conradie, Dr Maria Charumbira and Dr Eugene Nizeyimana for their assistance and guidance in this research.
The author reported that they received funding from the National Research Foundation Chair Initiative, which may be affected by the research reported in the enclosed publication. The author has disclosed those interests fully and has implemented an approved plan for managing any potential conflicts arising from their involvement. The terms of these funding arrangements have been reviewed and approved by the affiliated university under its policy on objectivity in research.
The authors, Quinette Louw (Editor-in-Chief) and Dawn Ernstzen (Editorial Board), serves as editorial board members of this journal. The peer review process for this submission was handled independently, and the authors had no involvement in the editorial decision-making process for this manuscript. The authors have no other competing interests to declare.
Q.L. conceptualised the study and obtained funding. G.B.P. drafted the initial article, while Q.L. and D.E. reviewed and revised it for intellectual content. All authors participated in designing the work, read through it thoroughly and endorsed its final version.
Ethical clearance to conduct this study was obtained from Stellenbosch University, Health Research Ethics Committee (Ref: S22/22/253).
Derived data supporting the findings of this study will be available from the corresponding author, G.B.P. on reasonable request.
The views and opinions expressed in this article are those of the authors and are the product of professional research. It does not necessarily reflect the official policy or position of any affiliated institution, funder, agency or that of the publisher. The authors are responsible for this article’s results, findings and content.
Search conducted on 22 March 2023.
Search strategy.
| Keyterms searched | Number of articles retrieved |
|---|---|
| patients [Text Word] OR clients [Text Word] OR caregivers [Text Word] OR carers [Text Word] OR “care givers” [Text Word] OR “spouse caregivers” [Text Word] OR “family caregivers” [Text Word] OR “informal caregivers” OR family [Text Word] OR “family member”[Text Word] OR relatives[Text Word] OR filiation [Text Word] | 7 893 207 |
| (((patient[MeSH Terms])) OR (caregivers [MeSH Terms])) OR (family [MeSH Terms]) | 472 088 |
| “digital technologies” [Text Word] OR “digital electronics” [Text Word] OR telerehabilitation [Text Word] OR tele-rehabilitation [Text Word] OR “tele rehabilitation” [Text Word] OR “remote rehabilitation”[Text Word] OR ‘virtual rehabilitation”[Text Word] | 5042 |
| (digital technologies [MeSH Terms]) OR (telerehabilitation [MeSH Terms]) | 1552 |
| rehabilitation [Text Word] | 362 892 |
| rehabilitation[MeSH Terms] | 349 112 |
| (((“semi-structured” [TIAB] OR semistructured [TIAB] OR unstructured [TIAB] OR informal [TIAB] OR “in-depth”[TIAB] OR indepth [TIAB] OR ‘face-to-face” [TIAB] OR structured [TIAB] OR guide[TIAB] OR guides [TIAB]) AND (interview* [TIAB] OR discussion* [TIAB] OR questionnaire* [TIAB])) OR (“focus group” [TIAB] OR “focus groups” [TIAB] OR qualitative [TIAB] OR ethnograph* [TIAB] OR fieldwork[TIAB] OR “field work” [TIAB] OR “key informant” [TIAB])) OR “interviews as topic”[Mesh] OR “focus groups” [Mesh] OR narration [Mesh] OR qualitative research[Mesh] OR “personal narratives as topic”[Mesh] | 548 997 |
| perceive* [Text Word] OR perception* [Text Word] OR exp Consumer Participation/OR*personal satisfaction/OR exp consumer Satisfaction/OR satis* [Text Word] OR exp Hospital-Patient Relations/OR exp Professional- Patient Relations/OR value* [Text Word] OR perspective* [Text Word] OR view*[Text Word] OR experience* [Text Word] OR need* [Text Word] OR exp “Health Services Needs and Demand “/OR issue* [Text Word] OR exp Attitude/OR belie* [Text Word] OR opinion* [Text Word] OR feel* [Text Word] OR know* [Text Word] OR understand* [Text Word] | 4 743 636 |
| All terms combined | 348 |