1- Vice Principal, College of Physiotherapy and Clinical Supervisor, Department of Neurology, Christian Medical College and Hospital, Ludhiana.
2- Consultant Department of Neurology
3- Senior Lecturer Department of Health Professions
4- Senior Research Fellow, Department of Physiotherapy, Kasturba Medical College, Mangalore
5- Physiotherapist and Research Coordinator, Department of Clinical Haematology
6- Senior Occupational Therapist, Dept of Neurology
7- Senior Physiotherapist and Research Associate, Department of Neurology
8- Principal (Dean) and Professor of Neurology
Abstract: (766 Views)
Abstract:
Objectives: The objectives of this study were:
(1) To explore the challenges to implementing physical rehabilitation for people with neurological diseases at in-hospital and community levels in India, (2) To summarize the unmet needs of evidence-based physical neurorehabilitation in India, (3) To explore the potential models/ services that can enhance the delivery of physical rehabilitation for people with neurological diseases in India
Methods: Following the PRISMA guidelines, a scoping review was conducted, employing predefined criteria to identify 28 eligible studies for analysis. Using a narrative synthesis approach, the authors collated and summarized the data extracted from these studies to gain insights into the challenges and current requirements for neurorehabilitation in India.
The narrative synthesis method facilitated the exploration of qualitative aspects, allowing for a comprehensive examination of the synthesized evidence.
Results: Rehabilitation after a stroke was the primary focus of the majority of the 28 research. Rehabilitation (a), rehabilitation (b) supply of rehabilitation, rehabilitation (c) research on rehabilitation, and socioeconomic issues (d) were the four main headings used to explain the present difficulties and unfulfilled demands. We also suggest eight "Models of Care" that are based on proven strategies that have been tested before and might help address current deficiencies.
Discussion: Neurorehabilitation in India is inadequate, with a lack of skilled professionals, poor accessibility to services, and a rural-urban divide. Alternative models of rehabilitation provision, including multidisciplinary care, task-shifting, caregiver-led, and self-help models, could address the unmet needs. Trials have explored home-based caregiver-led and technology-based models, but modifications and cultural specificity are needed. Stakeholders must mobilize support and advocate for rehabilitation's role and value, with improved data collection and reporting to inform policy development.
Conclusion: There is no one-size-fits-all solution to the diverse challenges and needs of neurorehabilitation delivery in India. Several alternative care models seem to have future promise, albeit the unfulfilled demands. Some basic steps towards progress include raising public awareness, enhancing the skills of current experts, and encouraging proactive engagement from state and federal governments and other interested parties.
Article type:
Reviews |
Subject:
Neurorehabilitation Received: 2023/03/31 | Accepted: 2024/04/27
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