# Digital Health Technology for Stroke Rehabilitation in Canada: A Scoping Review
## 1 Introduction  
Digital Health Technologies (DHTs) refer to the integration of information technology, communication networks, and healthcare systems to improve health outcomes [1]. This broad and evolving field includes innovations such as telemedicine, mobile health (m-health), electronic health (e-health), wearable devices, sensors, and artificial intelligence (AI) [2, 3, 4]. DHTs have become increasingly embedded in modern healthcare, facilitating notonly clinical diagnosis and treatment, but also long-term patient monitoring, data-driven decision-making, and remote research collaboration [1; 2]. The COVID-19 pandemic significantly accelerated the adoption of DHTs, reshaping healthcare delivery worldwide [5; 6]. In response to social distancing protocols, DHTs enabled remote patient care and ensured continuity of healthcare services during crisis periods [7]. One of the key advantages of DHTs is their ability to provide timely and accessible healthcare, particularly in underserved or remote regions. The effectiveness of these technologies has been well-documented, with numerous studies highlighting their role in improving patient outcomes, enhancing care coordination, and streamlining healthcare delivery [2; 8]. Consequently, DHTs have become integral to modern healthcare, contributing to both efficiency and accessibility [9]. [PERSON] et al. (2024) found out that DHTs could help improve communication, coordination, and information sharing between clinicians and patients during transition periods and recommended that further research be needed to assess the effectiveness of DHTs on patient outcomes [10]. Furthermore, current implementation methods in the field are inadequate. Digital interventions need well-planned, tailored implementation for successful adoption in rehabilitation [11]. Several researchers looked at the effectiveness of DHTs to support post-stroke recovery. A recent systematic review and meta-analysis examined the effectiveness of digital home rehabilitation for stroke survivors, finding that it has similar benefits to traditional home training or clinic-based services and could potentially replace them [12]. The implementation of DHTs varies globally, with both high-income and low- to middle-income countries adopting similar technologies for patient care and public health management [13]. However, research indicates that the application of digital health in stroke rehabilitation requires context-based approaches tailored to different countries and cultures [14]. Stroke is a major health issue in Canada, affecting approximately 405,000 individuals in 2013 with a prevalence rate of 1.15% [15], making effective rehabilitation critical for preventing further disability and enhancing participation in daily activities [16]. DHTs hold significant promise for improving stroke rehabilitation services, particularly by enhancing access to care in rural, remote, and Indigenous communities that face ongoing challenges in obtaining specialized services [17; 18]. Given the significant burden of stroke on individuals and healthcare systems [19], research focused on DHT use in stroke rehabilitation is crucial for the Canadian context. However, despite the potential benefits, Canada's unique healthcare landscape presents distinct implementation challenges not fully addressed in global studies [20]. Disparities in access and continuity of stroke rehabilitation services between urban and rural areas persist, and integration of advanced technologies into routine practice remains inconsistent [16; 21; 22]. Furthermore, a national survey by [PERSON] et al. (2023) reported low adoption rates of evidence based DHT interventions among Canadian therapists, primarily due to limited infrastructure, training, and institutional support [20]. These context-specific barriers highlight the need for a focused investigation within Canada. Therefore, this scoping review seeks to answer the following research questions:  
* How are DHTs used in stroke rehabilitation across Canada?