Telerehabilitation After Stroke Using Readily Available Technology: A Randomized Controlled Trial.

Area of Science:

• Neurology
• Rehabilitation Medicine
• Health Services Research

Background:

• Rising stroke prevalence necessitates innovative rehabilitation strategies.
• Telerehabilitation offers a scalable solution for post-stroke care and self-management.
• The Augmented Community Telerehabilitation Intervention (ACTIV) is a structured program combining remote and limited in-person support.

Purpose of the Study:

• To evaluate the efficacy of the ACTIV program in enhancing physical function post-stroke.
• To compare outcomes of ACTIV against usual care in stroke survivors.

Main Methods:

• A randomized controlled trial involving 95 first-ever stroke patients discharged home.
• Participants were randomized to either the ACTIV intervention or usual care.
• Blinded assessors measured physical function at baseline, post-intervention, and 6-month follow-up.

Main Results:

• Intention-to-treat analysis showed no significant difference in physical function between groups post-intervention (P = .07).
• Per-protocol analysis revealed a significant improvement in physical function for the ACTIV group (P = .04).
• Observed improvements in physical function were not sustained at 12-month follow-up.

Conclusions:

• ACTIV was not found to be effective overall in improving physical function compared to usual care.
• Per-protocol analysis suggests potential benefits for patients adhering to >50% of the ACTIV intervention.
• Further research may clarify ACTIV's role in preventing deterioration or improving function immediately post-discharge.