Try this at home: A systematic review of patient satisfaction with stroke telerehabilitation

Stroke rehabilitation improves patient outcomes, but requires timely delivery, sufficient intensity, and adequate participation in appropriate therapies for maximal effectiveness. Unfortunately, many patients experience barriers to accessing conventional in-person rehabilitation. Telerehabilitation may increase access to care and is increasingly used in clinical settings, particularly since the COVID-19 pandemic. However, little is known about patient satisfaction with telerehabilitation. The objective of this systematic review was to examine patient satisfaction with post-stroke motor telerehabilitation.

MEDLINE, EMBASE, and PsycINFO databases were searched from database inception to July 2025 inclusive. Two independent reviewers screened articles using the following inclusion criteria: English-language, full-text articles, reporting patient satisfaction outcomes with telerehabilitation for persons with stroke receiving upper or lower limb motor rehabilitation. Studies reporting only caregiver, but not patient satisfaction, were excluded. Study quality was assessed using the PEDro rating scale where appropriate.

After removing duplicates, 225 unique articles were reviewed. Nineteen studies published between 2007-2025 met inclusion criteria, assessing 811 individuals (n= 4-188, median 24) across 13 countries. Most studies were conducted in the outpatient setting; three were in both outpatient and inpatient settings. Fourteen studies (74%) examined telerehabilitation in the chronic phase post-stroke, two in the acute phase, two in the subacute phase, and one in both acute and subacute. Ten studies used telerehabilitation for upper limb motor impairment, two for lower limb, and seven for both. Eight controlled trials (seven randomized control trials and one non-randomized control trial) were assessed for quality with PEDro scores ranging from 4-8 (median 6). Assessment tools for patient satisfaction varied significantly between studies. Eight unique validated satisfaction tools were used across studies. All studies reported high patient satisfaction ratings with virtual motor telerehabilitation.

Although this review found that patient satisfaction ratings were high among studies of telerehabilitation for post-stroke motor impairment, there are few high-quality motor telerehabilitation studies, and none focused on satisfaction as their main outcome. Given the importance of telerehabilitation for removing barriers to care, future research should use standardized tools to explore patients' and providers' satisfaction in addition to evaluating efficacy.