Shifting neuromuscular rehabilitation to improve human functioning in low-resource settings

Neurorehabilitation for people with disability due to neurological disorders, such as stroke, traumatic brain injury, spinal cord injury, multiple sclerosis, and rehabilitation of musculoskeletal injuries, such as osteoarthritis and knee injuries, are time and recourse demanding and require long-term care. It is always a challenge to the healthcare system, patients and families, and society, especially in low-resource settings, to provide patients with appropriate long-term rehabilitation services. The low-resource setting environments include most regions in low-income countries and remote areas in high-income countries such as rural areas and areas with economic disadvantages. The under-served populations in low-resource settings often experience financial shortages, suboptimal healthcare service delivery, underdeveloped infrastructure, paucity of health-related knowledge, restricted social and human resources, and negative influence of geographical and environmental factors or beliefs and practices. The health inequalities in serving patients with neurological disorders or musculoskeletal impairment in low-resource settings are commonly recognized and need to be addressed.

Neurorehabilitation and musculoskeletal rehabilitation interventions are designed to optimize functioning and reduce disability in individuals with neurological and musculoskeletal conditions. Human functioning includes functions and structures of the body that constitute the intrinsic health capacity of human functions and structures of the body and the actual performance of simple and complex activities in interaction with the environment. The World Health Organization (WHO) recommends implementing human functioning as the third indicator of health (complementing mortality and morbidity), which could profoundly benefit practices, research, and policy across health systems and strategies.

In recent years, there been increased research efforts by research society to address the issue of health inequalities in rehabilitation in low-resource settings through various rehabilitation research and development activities. There have been studies of utilizing novel and low-cost technologies or implementing WHO-recommended task-shifting models and strategies suitable for low-resource settings. This special issue of Frontiers in Rehabilitation Sciences aims to introduce relevant research and development works on the topic in the field.