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Review
. 2022 Feb;269(2):627-638.
doi: 10.1007/s00415-021-10397-w. Epub 2021 Jan 15.

Telerehabilitation in response to constrained physical distance: an opportunity to rethink neurorehabilitative routines

Arturo Nuara  1   2   3 , Maddalena Fabbri-Destro  4 , Emilia Scalona  4 , Stefano Elio Lenzi  4 , Giacomo Rizzolatti  4   5 , Pietro Avanzini  4   6
Affiliations
Review

Telerehabilitation in response to constrained physical distance: an opportunity to rethink neurorehabilitative routines

Arturo Nuara et al. J Neurol. 2022 Feb.

Abstract

Ensuring proper dosage of treatment and repetition over time is a major challenge in neurorehabilitation. However, a requirement of physical distancing to date compromises their achievement. While mostly associated to COVID-19, physical distancing is not only required in a pandemic scenario, but also advised for several clinical conditions (e.g. immunocompromised individuals) or forced for specific social contexts (e.g. people living in remote areas worldwide). All these contexts advocate for the implementation of alternative healthcare models. The objective of this perspective is to highlight the benefits of remote administration of rehabilitative treatment, namely telerehabilitation, in counteracting physical distancing barriers in neurorehabilitation. Sustaining boosters of treatment outcome, such as compliance, sustainability, as well as motivation, telerehabilitation may adapt to multiple neurological conditions, with the further advantage of a high potential for individualization to patient's or pathology's specificities. The effectiveness of telerehabilitation can be potentiated by several technologies available to date: virtual reality can recreate realistic environments in which patients may bodily operate, wearable sensors allow to quantitatively monitor the patient's performance, and signal processing may contribute to the prediction of long-term dynamics of patient recovery. Telerehabilitation might spark its advantages far beyond the mere limitation of physical distancing effects, mitigating criticalities of daily neurorehabilitative practice, and thus paving the way to the envision of mixed models of care, where hospital-based procedures are complementarily integrated with telerehabilitative ones.

Keywords: Action observation treatment; Physical distancing; Remote rehabilitation; Social distancing; Virtual reality.

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Conflict of interest statement

All the Authors do not present conflict of interest. All authors approved the submission of the article.

Figures

Fig. 1
Fig. 1
The vicious circle involving social distance and neurological disability. Factors hurdling the continuity of rehabilitative pathways impede a favorable outcome, ending up in feeding social distancing itself
See this image and copyright information in PMC

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