Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jul 3, 2025
Date Accepted: Apr 10, 2026
Two Is a Pair, Three Is a Crowd: A Scoping Review of the Barriers and Facilitators to the Three Sides of XR-Rehabilitation Adoption
ABSTRACT
Background:
Telerehabilitation using Extended Reality technologies can be used to address the growing shortage of healthcare staff. Yet, the adoption of these tools remains very low.
Objective:
Determine what drives patients, clinicians and developers to adopt/develop XR-telerehabilitation tools, as well as how these drivers align and misalign.
Methods:
The PRISMA-ScR reporting guideline was followed. Studies were screened from PubMed, Embase, SCOPUS and Web of Science. All relevant empirical data was structured using the NASSS framework.
Results:
After analyzing forty-eight studies, we identified three main misalignments between patients, clinicians, and XR developers. Clinicians may not prescribe XR-tools to patients, because the tool does not meet their medical efficacy standards or because it impedes their work experience. The patient’s and clinician’s limited ability or willingness to pay also hinders developers from reaching sufficient economies of scale.
Conclusions:
Our scoping review is the first to demonstrate that the misalignment in drivers of patients, clinicians and developers generates systemic frictions that hinder the adoption of XR-based telerehabilitation tools. Both scholars and practitioners can use these insights to enhance the usage of XR in rehabilitation care. Clinical Trial: N/A
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