Quantifying the amount of physical rehabilitation received by individuals living with neurological conditions in the community: a scoping review

Abstract

Background: Physical rehabilitation is often prescribed immediately following a neurological event or a neurological diagnosis. However, many individuals require physical rehabilitation after hospital discharge. The purpose of this scoping review was to determine the amount of physical rehabilitation that individuals living in the community with neurological conditions receive to understand current global practices and assess gaps in research and service use.

Methods: This scoping review included observational studies that 1) involved adults living with a neurological condition, and 2) quantified the amount of rehabilitation being received in the community or outpatient hospital setting. Only literature published in English was considered. MEDLINE, EMBASE, AMED, CINAHL, Cochrane Library, and PEDro databases were searched from inception. Two independent reviewers screened titles and abstracts, followed by full texts, and data extraction. Mean annual hours of rehabilitation was estimated based on the amount of rehabilitation reported in the included studies.

Results: Overall, 18 studies were included after screen 14,698 articles. The estimated mean annual hours of rehabilitation varied greatly (4.9 to 155.1 h), with individuals with spinal cord injury and stroke receiving the greatest number of hours. Participants typically received more physical therapy than occupational therapy (difference range: 1 to 22 h/year). Lastly, only one study included individuals with progressive neurological conditions, highlighting a research gap.

Discussion: The amount of rehabilitation received by individuals with neurological conditions living in the community varies greatly. With such a wide range of time spent in rehabilitation, it is likely that the amount of rehabilitation being received by most individuals in the community is insufficient to improve function and quality of life. Future work should identify the barriers to accessing rehabilitation resources in the community and how much rehabilitation is needed to observe functional improvements.

Fig. 1

PRISMA diagram

Fig. 2

Year studies were published

Fig. 3

Estimated mean annual hours reported for each physical rehabilitation service, separated by neurological condition. Misc Neuro included stroke, traumatic brain injury, other acquired brain injury, spinal cord injury, peripheral neuropathy, and progressive long-term neurological conditions [26]

Fig. 4

Estimated mean annual hours separated by service type. PT = physical therapy; OT = occupational therapy. Note: some studies compared service use in multiple settings (e.g., in-home and outpatient) and thus have been reported twice [23, 25, 26]