Asia Pacific region: India

There is a growing demand for neurorehabilitation services in India, driven by the aging population and the increasing incidence/prevalence of stroke and other neuromuscular conditions. In India, the increasing incidence of stroke at a younger age compromises the quality of prime earning years, thus making the need for neurorehabilitation very relevant. High demand, lack of insurance coverage, high patient-to-clinician ratio (<10 therapists for 10 million patients), poor accessibility (except in tier I and tier II cities), the associated (in)direct costs to patients, and the lack of awareness about rehabilitation services are key contributing factors to the current state of unformed neurorehabilitation services in the country. Neurorehabilitation technology will be an essential part of the strategy to improve India’s overall neurorehabilitation care pathways. Although awareness and interest in such technological solutions have increased lately, the clinical uptake remains poor due to multiple factors. These include the high cost of existing commercial rehabilitation technologies, insufficient indigenous technology, limited awareness about rehabilitation technologies among clinicians and patients, and psychosocial/economic barriers. While focusing on upper-limb neurorehabilitation, the purpose of this chapter is threefold: (1) to provide a comprehensive summary of the neurorehabilitation landscape in India, along with the diverse demands and constraints of the country’s healthcare system; (2) to highlight the role of technology in addressing the current problems faced in improving neurorehabilitation in India; and (3) to take a critical look at the factors contributing to the poor clinical uptake of neurorehabilitation technology and to provide suggestions for clinicians, engineers, and researchers to bridge the gaps in neurorehabilitation services through technology.