According to the World Health Organization, life expectancy and chronic diseases (especially neurological disorders) increased exponentially in the last decade. Patients with neurological disorders often isolate themselves, stay long periods at home, and require care and attention from formal or informal caregivers (Ploeg et al., 2017; Dixe et al., 2019). Formal caregivers are professionals paid to take care of patients that need help in daily activities. The impact of the caring activity on quality of life and burden of formal caregivers differs from informal caregivers. In contrast, formal caregivers are paid and trained to meet the demands of patients and experience lower overload and stress than informal caregivers (Dixe et al., 2019).

Informal caregivers usually are family members with several responsibilities to help patients with disabilities (e.g., treat wounds, perform hygiene, and control medication, appointments, and therapy schedules), besides personal and professional responsibilities (Ploeg et al., 2017). The burden varies according to the needs of patients (Dixe et al., 2019) and may lead to acute and chronic physical disorders, isolation, depression, financial distress, and self-blame (Abreu Paiva et al., 2019). Moreover, they may present difficult intra-family relationships, economic impairments due to social stigma, and an increased probability of physical suffering (Nogueira et al., 2019). These caregivers are not considered professionals and receive limited training regarding basic care for patients with disabilities; (Chiao et al., 2015) therefore, they may experience intense burden, depression, pain, and low aerobic endurance compared with formal caregivers (Llach et al., 2004; Gusi et al., 2009; Farran et al., 2016).

The physical and psychological benefits of exercise on the daily life of caregivers are well-established (Lambert et al., 2016). For instance, exercise was associated with reduced self-reported stress, chronic diseases, and depressive symptoms and increased self-perception of wellbeing, quality of life, and mobility (Loi et al., 2014; Baik et al., 2021). However, the demands and responsibilities of the caregiver hamper their adherence to health promotion measures (Hearn et al., 2019).

In this context, telerehabilitation emerges as a tool to ensure greater health service efficiency. Telerehabilitation is defined as the delivery of rehabilitation interventions via telecommunication technologies and has been used to optimize time and demonstrate that users can have remote and effective access to physical and mental health, self-care, and physical exercise (Hearn et al., 2019). This strategy also presents several advantages (e.g., low travel costs and flexible schedules) and can be integrated into evaluation processes, health monitoring, and education (Van Egmond et al., 2018).

The health conditions of caregivers of patients with chronic diseases are often precarious due to self-care barriers (e.g., difficulties in displacement, living distant from urban centers, or lack of time; Saragiotto et al., 2020) therefore, new strategies must be developed to increase the access of caregivers to health services.

The acceptability and feasibility of telerehabilitation by patients and their caregivers is already proven in the literature (Geronimo et al., 2017). Furthermore, evidence related to telerehabilitation proves the ability of this type of intervention to reduce characteristics associated with caregiver burden, such as time and financial aspects, since, by carrying out the intervention remotely, the caregiver is able to reduce the time spent traveling and the financial resources consumed (Tindall and Huebner, 2009). In addition, interventions with telerehabilitation aiming at controlling caregiver stress and providing emotional care resulted in a reduction in participants' depressive complaints (Smith et al., 2012).

Moreover, studies using physiotherapy with telerehabilitation either focused on patient rehabilitation or proposed interventions to manage the burden of caregivers (Won et al., 2008; Prick et al., 2011; Forducey et al., 2012; Manceau et al., 2014; Yilmaz et al., 2019). Although well-established, Forducey et al. (2012) and Chen et al. (2017) literature still lacks evidence regarding the impact of physiotherapy with telerehabilitation on health of the caregiver. Thus, we outlined a systematic review protocol to evaluate the impact of telerehabilitation on the burden, stress, pain, and quality of life of caregivers of patients with neurological disorders.

Rehabilitation processes need to focus on the health of caregivers, who interpret caring as a duty and spend time and energy with others. Informal caregivers of patients with chronic diseases, especially neurological disorders, have intense physical and mental overload and may become ill due to stress, anxiety, and burden.

Telerehabilitation has been used as a strategy for patients with motor and neurological disorders and their caregivers. It can also be used for people who cannot leave the house due to lack of time, physical or mental health, or financial conditions. Besides, this approach has already been approved, due to comfort when using the tool, improvements in patient care, and in the caregiver's quality of life Chi and Demiris (2015). This review will summarize the impacts of telerehabilitation on the health of caregivers of patients with neurological disorders and subsidize the need for attention to their quality of life.

Most caregivers report difficulties in directing their time to their own activities, prioritizing patient care, and reducing their time for self-care (Son et al., 2007; Schulz and Sherwood, 2008). Thus, often physical illness, such as joint and muscle pain, or mental illness, such as stress and depression.

From our findings, telerehabilitation strategies for public health to systematize methods in order to improve the care for caregivers, identifying the better way to manage the assistance, use, aims, and outcomes. We will also highlight the need to focus on the health of caregivers of patients with neurological disorders.

Ethical review and approval was not required for the study on human participants in accordance with the local legislation and institutional requirements. Written informed consent for participation was not required for this study in accordance with the national legislation and the institutional requirements.

ES conceptualized the protocol and established eligibility criteria, data extraction framework, and wrote this manuscript. AS, LH, and LM have written this protocol. TR has elaborated on the strategy search. AL research project organization, manuscript review, and critique. RV manuscript review and critique. All authors made substantial contributions to this protocol, read, and approved the final version.

This study was partially funded by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) - Finance Code 001, National Council for Scientific and Technological Development and Ministry of Health, through a Decentralized Execution Term (TED 132/2018). The authors are also grateful to the Federal University of Rio Grande do Norte and the Brazilian Ministry of Education (MEC).

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.