KNOWLEDGE, USAGE AND CHALLENGES TO DIGITAL REHABILITATION AMONG REHABILITATION PROFESSIONALS IN EAST AFRICA: A CROSS-SECTIONAL MULTI-CENTER STUDY

The demand for rehabilitation services is increasing globally due to aging populations, rising chronic diseases, and higher accident rates. The World Health Organization (WHO) estimates that one in three people require rehabilitation, with this need expected to grow. However, there is a severe shortage of clinical rehabilitation professionals worldwide, particularly in East Africa, where practitioner density is far below recommended levels. Digital rehabilitation (DR) has emerged as a potential solution to bridge this gap by leveraging technology to improve service accessibility. However, research on DR implementation in East Africa remains limited. This study assessed rehabilitation professionals’ knowledge, usage, attitudes, and challenges related to DR in Rwanda, Uganda, Kenya, and Tanzania. A cross-sectional quantitative survey was conducted using an online questionnaire targeting 353 registered rehabilitation professionals. Data analysis was performed using SPSS-25 and Microsoft Excel, with descriptive statistics and Chi-square tests used to determine associations between variables. Out of 216 respondents (61.2% response rate), 77.3% (n=167) were aware of DR platforms, with the internet and social media being the primary sources of knowledge (26.3%, n=44). In terms of proficiency, 46.3% (n=100) had moderate DR knowledge, while only 13.4% (n=29) demonstrated high proficiency. Knowledge levels were significantly associated with years of experience (X² = 23.965; p=0.022) and country of practice (X² = 21.072; p=0.009). Regarding DR implementation, 87% (n=188) used ICT tools in rehabilitation, but only 31.5% (n=68) used dedicated DR systems, and just 11.1% (n=24) had designated spaces for DR at their workplaces. The most commonly used DR type was image-based rehabilitation (24.54%, n=53), and WhatsApp messaging and video calls (58.33%, n=126) were the most frequently used platforms. DR was primarily used for patient follow-ups (56.48%, n=122). A majority of respondents (78.7%, n=170) were familiar with ICT, 95.8% (n=207) were comfortable using ICT, and 87.5% (n=189) had a positive attitude toward DR. DR use was significantly associated with practitioners’ perception of it as a viable healthcare solution (X² = 13.252, p=0.001), enthusiasm for using ICT in patient care and education (X² = 16.327, p=0.003), and ICT familiarity (X² = 57.344, p<0.001). Key challenges included inadequate DR training (88.4%, n=191), poor collaboration between ICT experts and clinicians (73.1%, n=158), and unstable internet connections (67.6%, n=146). The study recommends DR training programs, establishment of dedicated DR facilities, and increased awareness to improve rehabilitation service accessibility in East Africa.