The use of telehealth in the management of people with spinal cord injury in Low-Middle-Income Countries during COVID-19 pandemic

BackgroundThe COVID-19 pandemic posed unprecedented challenges to healthcare systems globally, particularly in Low- and Middle-Income Countries (LMICs), making it difficult to provide regular care to people with SCI.ObjectiveThis paper aims to present the perspectives of healthcare professionals from LMICs on the use of telehealth and/or telerehabilitation in SCI care during the COVID-19 pandemic, highlighting its scope, tools, barriers, facilitators and future implications.MethodsA qualitative approach was employed to gather insights from seven leading SCI healthcare professionals from Bangladesh, India, Nepal, Pakistan, and South Africa through structured interviews and an online questionnaire. Secondary data from government reports, and peer-reviewed articles were also analyzed to contextualize the findings. This study focuses on narrative reporting without formal data analysis.ResultsHealthcare professionals utilized telehealth and/or telerehabilitation services for follow-ups, occupational therapy, physiotherapy, nursing care and other rehabilitation services (home modifications, peer counseling, and yoga). Commonly tools included WhatsApp, Facebook Messenger, Skype, Zoom and other video conferencing softwares. Barriers included poor internet connectivity, lack of standardized teleassessments and tele protocols, reimbursement issues, legal and privacy concerns.ConclusionsTelehealth and/or Telerehabilitation services have demonstrated their critical role in SCI care during COVID-19 pandemic in LMICs, offering ways to connect and maintain continuity of care through commonly used social media tools. To integrate telehealth as a viable and long-term model for future health crises in SCI care, it is essential to develop supportive policies, improve infrastructure, provide professional training, and establish standardized assessment measures and guidelines.