Mobile health solutions: An opportunity for rehabilitation in low- and middle income countries?

Abstract

Mobile health (mHealth) development has advanced rapidly, indicating promise as an effective patient intervention. mHealth has many potential benefits that could help the treatment of patients, and the development of rehabilitation in low- and middle-income countries (LMICs). mHealth is a low-cost option that does not need rapid access to healthcare clinics or employees. It increases the feasibility and rationality of clinical treatment expectations in comparison to the conventional clinical model of management by promoting patient adherence to the treatment plan. mHealth can also serve as a basis for formulating treatment plans and partially compensate for the shortcomings of the traditional model. In addition, mHealth can help achieve universal rehabilitation service coverage by overcoming geographical barriers, thereby increasing the number of ways patients can benefit from the rehabilitation service, and by providing rehabilitation to individuals in remote areas and communities with insufficient healthcare services. However, despite these positive potential aspects, there is currently only a very limited number of studies performed in LMICs using mHealth. In this study, we first reviewed the current evidence supporting the use of mHealth in rehabilitation to identify the countries where studies have been carried out. Then, we identify the current limitations of the implementation of such mHealth solutions and propose a 10-point action plan, focusing on the macro (e.g., policymakers), meso (e.g., technology and healthcare institutions), and micro (e.g., patients and relatives) levels to ease the use, validation, and implementation in LMICs and thus participate in the development and recognition of public health and rehabilitation in these countries.

Views of Service Users, Their Family or Carers, and Health Care Professionals on Telerehabilitation for People With Neurological Conditions in Ghana: Qualitative Study

“…In terms of technological factors, one of the main challenges was the lack of a stable internet connection to conduct a telerehabilitation session. This has been identified as one of the main barriers to successful implementation of telerehabilitation in many others studies in LMICs [ 4 , 14 , 15 , 20 ], especially in relation to the transfer of images or videos. There was also an appreciation that not all service users had access to a smartphone, as previously reported [ 5 , 16 ].…”

“…Telerehabilitation is defined as the provision of rehabilitation, including physiotherapy, speech and language therapy, and occupational therapy, over distance and, oftentimes, using communication technology [ 8 ]. Potential telerehabilitation technologies include telephone and video calls, apps, virtual reality, and robotics [ 4 ]. A recent review suggests that the telephone or video is the main media through which telerehabilitation is delivered worldwide [ 9 ].…”

We asked the experts: The evolving role of non‐technical skills for surgery in low‐ and middle‐income countries

“…Similarly, mHealth has been shown to have a role in medical and surgical rehabilitation. 10 These technologies rely on accurate communication and proficient decision-making, however under quite different conditions. It is therefore critical that NTS training develops in tandem to address the specific challenges that they pose.…”

“…In a surgical context, this may translate to increased available appointments, easier follow‐up, and more accessible public health messages. Similarly, mHealth has been shown to have a role in medical and surgical rehabilitation 10 . These technologies rely on accurate communication and proficient decision‐making, however under quite different conditions.…”

Rehabilitation: a key service, yet highly underused, in the management of young patients with sickle cell disease after stroke in DR of Congo

“…Incorporating VR solutions into rehabilitation services in LMICs is a highly innovative and ambitious project, fraught with potential dangers ( 44 ). The challenge is not only to implement VR in rehabilitation, but to raise awareness of the benefits of rehabilitation among healthcare professionals and the population ( 45 ).…”