Physiotherapy and Exercise‐Based Rehabilitation for Mental Health: A Two‐Decade Bibliometric Analysis of Global Trends, Thematic Evolution, and the Socioeconomic Vulnerability Gap (2006–2025)

BACKGROUND: Physical rehabilitation approaches-including exercise therapy, physiotherapy, and multidisciplinary rehabilitation-are increasingly recognized for their role in mental health care. To our knowledge, this is an early bibliometric effort that systematically maps the intersection of exercise-based interventions and mental health outcomes with particular attention to socioeconomic vulnerability, a dimension that remains under-researched, using a dual-database approach across 2 decades. METHODS: A systematic search was conducted in PubMed (via E-utilities) and OpenAlex (public REST API) on 10 July 2026, with a publication-date window of 2006-2025. After four-step deduplication (exact DOI, normalized-title, Jaccard ≥ 0.85, manual) and exclusion of the 96 records dated 2026, 5223 publications were retained. Bibliometric indicators were extracted using bibliometrix (v4.3.0) in R (v4.4.0) and VOSviewer (v1.6.20). RESULTS: Annual publications grew from 36 (2006) to 815 (2025), representing a 22.6-fold increase (CAGR ≈ 17.8%). Country of origin was attributable for 4238 records (81.1%); the most productive countries were the United States (608, 11.6% of all records; 14.3% of attributable), the United Kingdom (393, 7.5%; 9.3%), and Australia (341, 6.5%; 8.1%). Among attributable records, high-income countries contributed 75.9% versus 24.1% from middle-income economies-a pronounced representational inequality. Publications were distributed across a broad range of journals, with the most productive journal accounting for only 1.7% of the corpus. Three developmental phases emerged: Foundation (2006-2011), Expansion (2012-2018), and Acceleration (2019-2025). Keyword analysis revealed a shift toward telehealth, community-based rehabilitation, and implementation science. A keyword-based assessment identified that 242 publications (4.6%) explicitly referenced socioeconomic vulnerability, revealing it as an emergent but under-researched thematic cluster. This keyword-derived count is a sensitive upper-bound estimate; a manual 100-record audit indicated a 62.5% false-positive rate among flagged records (5 of 8 flagged records were false positives; 37.5% precision; see Supplementary S2). CONCLUSIONS: Research at the intersection of physical rehabilitation and mental health has grown substantially but remains concentrated in high-income countries. Socioeconomic vulnerability represents a critically underexplored dimension. The identification of socioeconomic vulnerability as a fragmented and under-researched thematic cluster provides clear direction for future work. Future research should prioritize low-resource settings, cost-effectiveness evaluations, and implementation science to translate evidence into equitable, policy-relevant interventions. Building on the descriptive patterns reported here, future research-beyond the scope of the present bibliometric study-could explore innovative global-health financing mechanisms such as Debt-to-Health swaps to address the socioeconomic vulnerability gap; these are hypotheses for future inquiry rather than conclusions supported by the present data.