Understanding experiences and the impact of accessing physical rehabilitation services and assistive products for orthosis and wheelchair users in Cambodia: A qualitative study (Preprint)

BACKGROUND Access to physical rehabilitation services, including orthotics and wheelchairs, is recognised as a fundamental human right but remains limited in many LMICs due to resource constraints, fragmented care, and a shortage of trained providers. In Cambodia, where the health system still faces challenges from past conflict, these services are delivered through a mix of government, international, and non-governmental organisations. OBJECTIVE This study investigates the pathways to obtaining orthoses and wheelchairs in Cambodia and their impact on individuals with physical impairments. METHODS Semi-structured interviews were conducted to explore experiences and the impact of accessing physical rehabilitation and assistive products for orthosis and wheelchair users. Interviews were conducted face-to-face with translation support, audio-recorded, transcribed, and analysed using thematic analysis. Interviews were conducted with participants in Phnom Penh and Kandal province in Cambodia. In total, 17 participants took part in the study aged 18-65 years and were current or previous users of Exceed Worldwide physical rehabilitation centre located in Phnom Penh. RESULTS Three themes were developed: early experiences of illness and healthcare-seeking, pathways to assistive products, and the impact of these assistive products. Access to orthoses and wheelchairs often involved lengthy delays and inconsistent experiences with medical care and physiotherapy. Despite these challenges, assistive products played a vital role in improving mobility, independence, and social participation, contributing to greater confidence and emotional wellbeing. However, issues such as poor environmental accessibility and delays in repair or replacement limited their effectiveness. CONCLUSIONS The findings demonstrate that while assistive products offer significant benefits, they do not fully address the systemic barriers faced by people with physical disabilities in Cambodia. Persistent challenges, such as stigma, environmental constraints, and emotional strain, demonstrate the need for integrated policy reforms and a robust continuum of care that ensures coordinated, ongoing support across all stages of rehabilitation.