Feasibility and Utility of Tele-Neurorehabilitation Service in India: Experience from a Quaternary Center

Abstract

Background:Neurological rehabilitation service in developing countries like India is a great challenge in view of limited resources and manpower. Currently, neurological rehabilitation with a multidisciplinary team is limited to a few major cities in the country. Tele-neurorehabilitation (TNR) is considered as an alternative and innovative approach in health care. It connects the needy patients with the health-care providers with minimum inconvenience and yields cost-effective health care.Aim:The aim of this study was to study the socioclinical parameters, feasibility, and utility of TNR services in India.Methodology:A retrospective file review of TNR consultations provided through Telemedicine Center at a quaternary hospital-based research center in south India between August 2012 and January 2016.Results:A total of 37 consultations were provided to the patients belonging to four districts of Karnataka. The mean age of the patients was 34.7 (±19.5) years, 23 (62.1%) were aged between 19 and 60 years, and 31 (83.8%) were male. Thirty-one patients (83.8%) had central nervous system-related disorders such as stroke, cerebral palsy, and tubercular meningitis with sequelae or neuromuscular disorders such as Guillain–Barre Syndrome and Duchenne muscular dystrophy. Twelve patients (32.4%) were advised to consult higher centers in the vicinity, and the rest was referred to the district hospital.Conclusion:The findings suggest that TNR services are feasible, effective, and less resource intensive in delivering quality telemedicine care in India. More clinical studies are required to elucidate its full utility at different levels and in different parts of the country.

Impact of COVID-19 outbreak on mental health and perceived strain among caregivers tending children with special needs

“…Moreover, to provide solutions to global disease and to better battle against this current pandemic, tele-rehabilitation should have a greater emphasis wherever feasible. Poor utilization and acceptance of tele-health service was also observed in another Indian study ( Khanna et al, 2018 ). The overlooked barriers in a developing country such as poverty, confidentiality, privacy and cross-cultural acceptance of tele-rehabilitation strategies are the probable factors for the negative perception of tele-rehabilitation warrant future exploration ( Khan et al, 2015 ).…”

Challenges to the Emergence of Telerehabilitation in a Developing Country: A Systematic Review

“…For instance, Canada and Australia use telerehabilitation to enhance access across vast geographical landscapes and minimize economic barriers by reducing travel time and costs ( 44 , 45 ). Meanwhile, India, a lower-middle-income country ( 6 ), has a teleneurorehabilitation program to remotely provide cost-effective services amidst limited medical resources ( 46 ). Each country that has adopted telerehabilitation even before the pandemic acts according to the needs of its people and healthcare system.…”

Deep Cerebellar Transcranial Direct Current Stimulation of the Dentate Nucleus to Facilitate Standing Balance in Chronic Stroke Survivors—A Pilot Study

“…Tele-rehabilitation is also justified since functional improvements have been found to be equal for telerehabilitation and virtual reality (VR)-based training when compared to a similar intervention with therapist-supervision in the clinic [72]. Therefore, we propose testing of the effectiveness of a low-cost neurotechnology platform [23] for remote (smartphone-based) patient care and monitoring through the hub and spoke model (HSM) of telemedicine that is not only necessary to create a large patient outcome dataset but is also crucial to meet the growing needs of stroke survivors in India [85,86]. In the HSM of neurorehabilitation, the service delivery assets into a network consist of an anchor establishment (hub) which will offer a full array of services, complemented by secondary community-based establishments (spokes) that can offer local neurorehabilitation service arrays, routing patients needing more intensive services to the hub for treatment.…”