Game-based telerehabilitation in neurological disorders: a systematic review of features, opportunities and challenges

This study explores the integration of telerehabilitation, virtual reality, and serious games technologies in addressing physical disabilities. Specifically, it focuses on game-based telerehabilitation for patients with stroke, Parkinson's disease, and multiple sclerosis undergoing home-based rehabilitation. Utilising the PICO approach, a search in Scopus and PubMed until February 21st, 2024, identified 31 relevant English articles out of 258 initially considered. The study employed three independent reviewers to select, extract data, and analyse studies based on the research question. The final included studies were analysed to extract and categorise the most critical items, including rehabilitation tools, opportunities, and challenges. Of the 258 studies, 31 met the eligibility criteria, with the majority conducted in the United States and the United Kingdom. Key opportunities identified include the effectiveness of telerehabilitation and the use of new, engaging, user-friendly, and affordable technologies. However, challenges such as motivation, usability, exercise adherence, and technical barriers were significant. The Wii gaming console emerged as the most commonly used telerehabilitation device. This systematic review offers a comprehensive analysis of telerehabilitation features, opportunities, and challenges. It highlights the importance of tailored remote rehabilitation programs, potentially leading to more effective patient services. The study suggests that sustained use of these systems is crucial for positive clinical outcomes and emphasises the impact of affordability and engagement on long-term patient adherence to treatment plans in remote rehabilitation systems.