Barriers and Challenges of Implementing Telerehabilitation: A Systematic Review

Background: Telerehabilitation (TR) is an alternative approach for providing rehabilitation services in some situations, like Coronavirus Disease 2019 (COVID-19)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 2011 to February 2021. Search results in all databases provided a total of 598 articles. After reviewing the titles of the articles, we excluded 574 articles as they were duplicated and/or irrelevant. Finally, based on the inclusion and exclusion criteria, 11 articles have remained. Results: Most extracted articles were published in 2020 (n=4). The remaining articles disturbed between 2013 until 2021. These articles were mostly reviews, case reports/series, or qualitative studies and surveys. Geographically, 27% of the final selected papers belonged to the USA, 46% to Asia, and 27% to Europe. Outcomes in studies mostly included TR advantages and disadvantages, facilitators, challenges, and barriers. Conclusion: 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.