Abstract
A structured review using the PRISMA guidelines, MeSH keywords and eight health databases was conducted (1990 to March 2021). Telerehabilitation research evidence from the Middle East and North Africa region (MENA) was summarized. Twelve studies from Iran, Israel, Morocco, and Saudi Arabia met inclusion criteria; nearly all had been published within the past five years. Methodological quality was moderate to good in the four randomized controlled trials, five cohort-studies and three cross-section surveys. There were seven intervention studies in cardiovascular, musculoskeletal, neurology or burn rehabilitation and three patient perception and two practitioner perception studies. Narrative synthesis revealed content themes relating to rehabilitation availability and accessibility; patient/practitioner perceptions of telerehabilitation; telerehabilitation to augment traditional services; and barriers to telerehabilitation. Telerehabilitation practice in MENA has been demonstrated as feasible, acceptable to patients, and effective in practitioner-designed cohort specific programs. Practitioners are generally positive but lack experience and need training, enabling technological systems, and policy frameworks.
Highlights
Rehabilitation is an integral part of health systems, supporting people who have or are at risk of having disability to maximise their ability to engage in everyday activities and fully participate in their life situations (World Health Organization [WHO], 2017; WHO, 2020)
Narrative synthesis revealed content themes relating to rehabilitation availability and accessibility; patient/practitioner perceptions of telerehabilitation; telerehabilitation to augment traditional services; and barriers to telerehabilitation
According to the classification used by Human Rights Watch (2020), the countries in Middle East and North Africa region (MENA) are: Algeria, Bahrain, Egypt, Iran, Iraq, Israel/Palestine, Jordan, Kuwait, Lebanon, Libya, Mauritania, Morocco/Western Sahara, Oman, Qatar, Saudi Arabia, Syria, Tunisia, the United Arab Emirates, and Yemen
Summary
Rehabilitation is an integral part of health systems, supporting people who have or are at risk of having disability to maximise their ability to engage in everyday activities and fully participate in their life situations (World Health Organization [WHO], 2017; WHO, 2020). Telerehabilitation is the delivery of rehabilitation services using information and communication technologies (Hung & Fong, 2019; McCue, Fairman & Pramuka, 2010; Molini-Avejonas et al, 2015; Nafai, Barlow & Stevens-Nafai, 2017). Sites for telerehabilitation services can include homes, clinics, schools, residential care homes, and other community facilities (Piron et al, 2008; Schutte et al, 2012) Using such technology for remote delivery of services can make rehabilitation more accessible and available (Brennan, Mawson & Brownsell, 2009; Peretti et al, 2017), assisting patients to overcome barriers to program participation (Peretti et al, 2017; Tenforde et al, 2017). Telerehabilitation has, for example, been recommended in MENA, as a rehabilitation delivery approach in Morocco (Nafai et al, 2017), and as an alternative to in-person consultation during the COVID-19 pandemic (Abolghasemian et al, 2020; Qureshi et al, 2021; Ziadé et al, 2020)
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