Implementation of digital health interventions in rehabilitation: A scoping review

Louise Pearce, Cathie Sherrington, Nathalia Costa, Leanne Hassett

Background: Digital health interventions hold significant potential to address key rehabilitation issues such as accessibility, affordability, and scalability. However, such interventions are being implemented in rehabilitation settings inconsistently and with variable success. It is therefore important for research in this field to simultaneously evaluate the implementation and efficacy of digital health interventions in rehabilitation.

Aims: To map the current evidence available regarding the implementation of digital health interventions in rehabilitation.

Methods: Comprehensive searches of nine relevant electronic databases were performed. Inclusion criteria consisted of experimental studies in which rehabilitation clinicians delivered digital interventions (e.g., telerehabilitation, wearable devices, robotics, virtual reality, exergaming, smartphone apps) and methods of implementation were reported.

Results: A total of 11,207 papers were retrieved through searches and are being screened by two independent reviewers. The screening and data extraction process are on track to be completed for analysis to commence in December 2021. Implementation strategies will be categorised based on grouped concepts. Implementation outcomes (adoption, dose delivered, reach, fidelity, sustainability), determinants (context, acceptability, adaptability, feasibility, compatibility, cost, culture, dose satisfaction, complexity, self-efficacy) and frameworks will also be reported. Decision-making processes for selecting implementation strategies will be analysed and a preliminary indication of the impact of specific implementation strategies on the adoption of digital interventions by rehabilitation clinicians will be reported.

Conclusions: The findings of this scoping review will serve to guide future research in digital health implementation within rehabilitation and assist rehabilitation organisations and clinicians in evidence-based implementation of digital health interventions."