Home-based functional electrical stimulation protocol for people with chronic stroke. Efficacy and usability of a...

Stroke survivors often face challenges in recovery and reintegration after acute care. Home-based rehabilitation, incorporating advanced technologies like Functional Electrical Stimulation (FES), shows promise for improving long-term outcomes by providing more accessible, high-intensity, and task-oriented rehabilitation outside traditional clinical settings.

This study assessed efficacy and usability of a 10-week home-based rehabilitation protocol for 52 individuals with chronic stroke. The intervention featured a cloud-based platform, a mobile application, and functional electrical stimulation devices. Participants were categorized into groups for tailored exercise training and received both synchronous and asynchronous sessions. Efficacy was measured through standardized motor function tests, while usability was evaluated based on adherence, patient satisfaction, and the frequency of technical support requests.

High adherence (74.03%) and a satisfaction of 73% were observed. On average, patients performed on average 414 min of unsupervised exercise per week. Significant improvement, including a median decrease of 6.08 s (22%) in Timed Up and Go (TUG) [z (24) = 4.17, p < 0.001], a median decrease of 4.04 s (17%) in Five Times Sit to Stand (5STS) [z (28) = 3.96, p < 0.001], Motor Assessment Scale (MAS) showed a mean increase of 3.2 ± 2.8 points, paired t-test [t (20) = -5.01 p < 0.001] and an increase of 0.095 m/s (28%) in 10-Meter Walk Test (10MWT) [z (24) = 3.71, p < 0.001]. Clinical relevance was observed in all outcome measures compared with the reported Minimum Detectable Change.

This evaluation of a home-based physiotherapy protocol indicates that integrating FES devices with virtual platforms and mobile applications can sustain high adherence while improving functional outcomes in chronic stroke rehabilitation. The prescription of high-intensity training, significant improvements in balance, gait, and overall functionality were observed, highlighting the viability of this approach for home-based programs.