Telerehabilitation assessment domains and process in chronic diseases: a scoping meta-review

Background Telerehabilitation (TR) interventions are receiving increasing attention. They have been evaluated in various scientific areas through systematic reviews. However, there is a lack of data on how to standardize assessment and report on their domains to guide researchers across studies and bring together the best evidence to assess TR for chronic diseases.Aims and Objectives The aim of this study is to identify domains of assessment in TR and to qualitatively and quantitatively analyze how they are examined to gain an overview of assessment in chronic disease and understand the complexity of TR interventions.Methods A scoping meta-review was carried out on 9 databases and gray literature from 2009 to 2019. The keyword search strategy was based on "telerehabilitation", “evaluation", “chronic disease" and their synonyms. All articles were subjected to qualitative analysis using the Health Technology Assessment (HTA) Core Model prior to further analysis and narrative synthesis.Results Among the 7412 identified articles, 80 studies met the inclusion criteria. Regarding the domains of assessment, the most frequently occurring were “social aspect” (n = 63, 79%) (e.g., effects on behavioral changes) and “clinical efficacy” (n = 53, 66%), and the least frequently occurring was “safety aspects” (n= 2, 3%). We also identified the phases of TR in which the assessment was conducted and found that it most commonly occurred in the pilot study and randomized trial phases and least commonly occurred in the design, pretest, and postintervention phases.Conclusions Through the HTA model, this scoping meta-review highlighted the multidisciplinarity and comprehensiveness of TR assessment in the recent literature. Future studies will benefit from approaches that leverage the best evidence regarding the assessment of TR interventions, and it will be interesting to extend this assessment framework to other chronic diseases.