Telerehabilitation services for stroke.

Area of Science:

• Neurology
• Rehabilitation Medicine
• Health Informatics

Background:

• Telerehabilitation utilizes information and communication technologies for remote patient-provider interaction.
• Its viability increases with advancements in communication technology.
• Current evidence on its effectiveness relative to face-to-face rehabilitation is limited.

Purpose of the Study:

• To assess telerehabilitation's impact on activities of daily living (ADL) in stroke survivors compared to in-person therapy or usual care.
• To evaluate secondary outcomes including independence, mobility, quality of life, mood, and function.
• To report on adverse events, cost-effectiveness, feasibility, and user satisfaction.

Main Methods:

• Systematic review and meta-analysis of randomized controlled trials (RCTs) comparing telerehabilitation with in-person or no rehabilitation.
• Searched multiple databases including Cochrane Stroke Group Trials Register, CENTRAL, MEDLINE, and Embase.
• Included studies with varying interventions like post-hospital discharge support, upper limb training, and communication therapy.

Main Results:

• Moderate-quality evidence shows no difference in ADL between telerehabilitation and usual care (2 studies, 661 participants).
• Low-quality evidence indicates no difference in ADL between telerehabilitation and in-person therapy (2 studies, 75 participants).
• No significant differences were found for balance, quality of life, or depressive symptoms; evidence for mobility and satisfaction was insufficient.

Conclusions:

• Current low to moderate-quality evidence suggests telerehabilitation is not inferior to in-person therapy for stroke survivors.
• Short-term post-hospital telerehabilitation did not improve ADL, mood, or quality of life compared to usual care.
• Further high-quality research is necessary to definitively establish telerehabilitation's efficacy, cost-effectiveness, and feasibility.