Background: Neurological disorders represent a significant global health burden, often leading to long-term disability and increased healthcare costs. Neurological physiotherapy plays a vital role in improving functional outcomes, but it is resource-intensive, necessitating evaluation of both clinical and economic effectiveness. Objective: To review and synthesize existing evidence on the role of economic evaluation in neurological physiotherapy and its implications for clinical practice and healthcare decision-making. Methods: A narrative review was conducted using databases including PubMed, Scopus, Web of Science, CINAHL, PEDro, and Google Scholar. Keywords such as economic evaluation, cost-effectiveness, neurorehabilitation, and various neurological conditions were used. Studies involving economic analyses (cost-effectiveness, cost-utility, and cost-benefit) in neurological physiotherapy were included. A qualitative synthesis was performed based on type of evaluation, clinical outcomes, and economic findings. Results: Most studies reported cost-effectiveness and cost-utility analyses, commonly using incremental cost-effectiveness ratios (ICERs) and quality-adjusted life years (QALYs). Neurological physiotherapy interventions were generally found to be cost-effective, particularly task-specific and intensive rehabilitation approaches. Community-based and home-based rehabilitation reduced healthcare costs while maintaining comparable outcomes. Telerehabilitation demonstrated cost-effectiveness, whereas advanced technologies such as robotics and virtual reality showed mixed economic results due to high initial costs. Key gaps included limited data from low- and middle-income countries, short follow-up durations, and underreporting of indirect costs. Conclusion: Economic evaluation is essential in neurological physiotherapy to balance costs with patient outcomes. Evidence supports the cost-effectiveness of many physiotherapy interventions, especially when long-term benefits are considered. Future research should incorporate long-term and societal perspectives to enhance decision-making and ensure sustainable neurorehabilitation services.
