A scoping literature review of rehabilitation policy recommendations during the COVID-19 pandemic in the WHO European Region

Background: As with other frontline healthcare services, the delivery of rehabilitation services has been greatly affected by the COVID-19 pandemic with many services suspended, despite WHO's mandate that rehabilitation is an essential service. Objective: This review aimed to provide an overview of policy responses that were taken across the WHO European Region to identify systems and processes that helped to inform and shape decisions pertaining to rehabilitation during the COVID-19 pandemic. Methods: A scoping literature search was conducted according to PRISMA-ScR guidelines and prospectively registered on Prospero (ID: CRD42024550641). Cinahl, Cochrane, PubMed and Scopus databases were searched from inception to February 2024. Eligibility criteria for selecting publications: Published work that includes any policy documents that informed rehabilitation during the COVID-19 pandemic in any of the 53 World Health Organisation European member states. Search results were extracted using the PESTLE heading framework in Microsoft Excel. Results: Seven publications comprising seven policy documents from Italy (N=2), England (N=2) and the United Kingdom (N=3) were included in this review. Five key areas were identified in response to COVID-19 and rehabilitation: 1) government direction, 2) funding, 3) education, 4) telerehabilitation, and 5) social distancing and isolation. Conclusions: Our study's findings demonstrate a dearth of published government policy documentation referring to rehabilitation in response to the COVID-19 pandemic. This lack of published documents indicates that rehabilitation is not considered an essential health service during emergency response. Research should investigate the systems and processes of key decision-makers to inform future rehabilitation pandemic preparations.