Barriers to Rehabilitation Among Road Traffic Accident Survivors in Karachi: Clinical Reflections from a Public Sector Setting - Letter to Editor

Road traffic accidents (RTAs) are a major cause of injury and disability in Karachi, with many survivors requiring prolonged rehabilitation. However, adherence to physiotherapy in public hospitals remains inconsistent. This commentary draws on recurring clinical observations from a tertiary care public hospital and integrates available local and international literature to highlight common barriers to rehabilitation among RTA survivors. Financial constraints, work-related pressures, transport difficulties, limited awareness regarding the importance of physiotherapy, pain during therapy, and overcrowded outpatient departments were frequently observed. Psychosocial factors, including emotional distress and reduced motivation, further contributed to early discontinuation of rehabilitation. These socioeconomic and structural challenges negatively affect functional recovery and increase the risk of long-term disability. Addressing these barriers through patient education, improved accessibility, community-based rehabilitation models, and strengthening public-sector rehabilitation services is essential to improve outcomes for RTA survivors in resource-limited settings. Keywords: Barriers, Physiotherapy adherence, Public hospitals, Rehabilitation, Road traffic accidents DOI: 10.53389/JRCRS.2026140311