Low-Cost Telerehabilitation in Low- and Middle-Income Countries (LMICs): Overcoming Barriers to Access and Improving Healthcare Delivery.

Abstract

BackgroundTelerehabilitation (TR) holds promise for addressing healthcare disparities in low- and middle-income countries (LMICs), where access to rehabilitation services is often limited due to economic, geographical, and infrastructure barriers. Despite its potential, TR faces unique challenges in LMICs, including inadequate digital infrastructure, limited access to affordable devices, and variable internet connectivity.ObjectiveThis study investigates the feasibility, barriers, and outcomes of implementing low-cost TR interventions in LMICs.MethodA narrative review was conducted where studies were analyzed for outcomes including cost-effectiveness, patient adherence, and clinical efficacy.ResultsFindings indicate that low-cost TR can significantly improve accessibility to rehabilitation in LMICs, with positive clinical outcomes for patients with stroke, musculoskeletal disorders, and chronic pain. TR led to a 40-60% reduction in travel-related costs for patients, with adherence rates comparable to in-person sessions. However, limited access to reliable internet and devices were major barriers, particularly in rural areas, highlighting a digital divide within LMIC populations. Innovative solutions, such as asynchronous video-based therapy, were found effective in overcoming connectivity challenges.ConclusionLow-cost TR is a viable approach to enhancing rehabilitation accessibility in LMICs, offering substantial reductions in cost and travel barriers. Addressing infrastructure challenges through scalable, offline-enabled platforms could enhance TR's reach and efficacy. Further research is necessary to develop sustainable TR models tailored to the specific needs of LMICs.