Benefits and Challenges of Community-Based Rehabilitation in Rural Stroke Patients: A Scoping Review

다국어 초록 (Multilingual Abstract)

Purpose: This scoping review explored the benefits and challenges of community-based rehabilitation (CBR) for stroke patients residing in rural areas, who often experience limited access to healthcare services.
Methods: This review was conducted using the Arksey and O'Malley framework. The literature published between 2013 and 2023 was identified through searches of four databases (PubMed, EBSCOhost, ScienceON, and DBpia) using keywords, such as "stroke," "rehabilitation," "rural areas," and "community." Fifteen studies met the inclusion criteria.
Results: Among the 15 studies identified, the majority (73.33%) were quantitative, comprised of randomized controlled trials and cross-sectional designs. Most studies originated from China (50%) and North America (31.25%). The interventions were primarily community- and home-based. Commonly used assessment tools included the Barthel Index (BI), Caregiver Strain Index (CSI), and Hospital Anxiety and Depression Scale (HADS). This review emphasizes the methodological diversity and critical role of family and caregiver support in rural stroke rehabilitation.
Conclusion: CBR benefits rural stroke patients by improving functional recovery, enhancing the quality of life, and reducing the caregiver burden while being cost-effective. Among the various intervention types, home-based programs and those using information and communication technology (ICT), such as smartphone applications and telerehabilitation, were particularly effective in improving accessibility and adherence. The personalized, home-centered approach of CBR addresses the diverse needs of rural populations. Strengthening the service provider capacity and developing supportive policies are essential for ensuring the sustainability of CBR and reducing urban-rural disparities in rehabilitation access.