Effects of Telerehabilitation Versus Supervised Clinical Rehabilitation in Stroke Patients for Recovery of Motor Function: A Systematic Review
DOI:
https://doi.org/10.36283/pjr.zu.14.2/003Keywords:
Digital, Motor Function, Stroke, Telerehabilitation, Virtual RealityAbstract
Background of the study: Telerehabilitation, which involves delivering physical, occupational, speech, and other therapies under remote supervision, represents a potential approach to addressing motor, cognitive, and neuropsychiatric problems in stroke survivors. This systematic review aimed to determine the effects of supervised clinical rehabilitation and telerehabilitation on stroke patients' ability to recover motor function.
Methodology: A comprehensive search was conducted from July 2014 to July 2024 across multiple databases including Google Scholar, PubMed, PEDro, CINAHL, and Cochrane Library using keywords related to stroke and telerehabilitation. Studies examining stroke survivors receiving physiotherapy in clinical settings or through telerehabilitation were assessed for motor function outcomes. Inclusion criteria comprised randomized controlled trials evaluating different interventions for motor function recovery. Eleven publications provided data for the study, and the Cochrane risk of bias assessment tool was used to evaluate article quality.
Results: Study results showed no significant differences between the intervention group (receiving telerehabilitation) and control group (receiving clinical interventions) across all motor function outcomes, including fine and gross motor skills, functional mobility, and fine dexterity. However, significantly higher patient satisfaction was observed in the telerehabilitation group.
Conclusion: Results demonstrate that telerehabilitation effectively improves motor function in stroke patients as an alternative to in-person rehabilitation. Telerehabilitation successfully overcomes access barriers for long-term rehabilitation, leading to better recovery outcomes and enhanced patient satisfaction.
References
Béjot Y, Bailly Hurier J, et al. Epidemiology of stroke in Europe and trends for the 21st century. Presse Med 2016; 45: e391–e3e8.
M. Dunbar and A. Kirton, "Perinatal stroke," Seminars in Pediatric Neurology, vol. 32, article 100767, 2019.
Ogunniyi A. Global evidence generation. Oxford Textbook of Neurologic and Neuropsychiatric Epidemiology. 2020 Nov 2;27(23,032,796):453.
Eraifej J, Clark W, France B, et al. Effectiveness of upper limb functional electrical stimulation after stroke for the improvement of activities of daily living and motor function: a systematic review and meta-analysis. Syst Rev. 2017;6(1):40.
S. J. Henderson, J. I. Weitz, and P. Y. Kim, "Fibrinolysis: strategies to enhance the treatment of acute ischemic stroke," Journal of Thrombosis and Haemostasis, vol. 16, no. 10, pp. 1932 1940, 2018.
Rogers G, Davies D, Pink J, et al. Parkinson's disease: Summary of updated NICE guidance. Bmj 2017; 358.
Johansson, T., & Wild, C.(2011). Telerehabilitation in stroke care--a systematic review. Journal of Telemedicine and Telecare, 17(1), 1–6.
Nikolaev VA, Nikolaev AA. Recent trends in telerehabilitation of stroke patients: A narrative review. NeuroRehabilitation. 2022 Jan 1;51(1):1-22.
Laver KE, Adey-Wakeling Z, Crotty M, et al. Telerehabilitation services for stroke. Cochrane Database Syst Rev. 2020;1(1):CD010255.
Hernandez A, Bubyr L, Archambault PS, Higgins J, Levin MF, Kairy D. Virtual reality--based rehabilitation as a feasible and engaging tool for the management of chronic poststroke upper-extremity function recovery: Randomized controlled trial. JMIR Serious Games. 2022 Sep 27;10(3):e37506.
Perle JG, Zheng W. A primer for understanding and utilizing telesupervision with healthcare trainees. Journal of Technology in Behavioral Science. 2024 Mar;9(1):46-52.
Appleby E, Gill ST, Hayes LK, Walker TL, Walsh M, Kumar S. Effectiveness of telerehabilitation in the management of adults with stroke: A systematic review. PloS one. 2019 Nov 12;14(11):e0225150.
Conroy SS, Harcum S, Keldsen L, Bever Jr CT. Novel use of existing technology: a preliminary study of patient portal use for telerehabilitation. Journal of Telemedicine and Telecare. 2022 Jun;28(5):380-8.
Gauthier LV, Nichols-Larsen DS, Uswatte G, Strahl N, Simeo M, Proffitt R, Kelly K, Crawfis R, Taub E, Morris D, Lowes LP. Video game rehabilitation for outpatient stroke (VIGoROUS): a multi-site randomized controlled trial of in-home, self-managed, upper-extremity therapy. EClinicalMedicine. 2022 Jan 1;43.
Krpic A, Savanovic A, Cikajlo I. Telerehabilitation: remote multimedia-supported assistance and mobile monitoring of balance training outcomes can facilitate the clinical staff's effort. International journal of rehabilitation research. 2013 Jun 1;36(2):162-71.
Higgins JPTTJ, Chandler J, Cumpston M, et al. Cochrane handbook for systematic reviews of interventions version 2021; 6: p. 22021.
Shamweel H, Gupta N. Constraint-induced movement therapy through telerehabilitation for upper extremity function in stroke. Journal of Neurorestoratology. 2024 Jun 1;12(2):100108. https://doi.org/10.1016/j.jnrt.2024.100108
Saygili F, Guclu‐Gunduz A, Eldemir S, Eldemir K, Ozkul C, Gursoy GT. Effects of modified constraint induced movement therapy based telerehabilitation on upper extremity motor functions in stroke patients. Brain and Behavior. 2024 Jun;14(6):e3569.
Zhang Y, Jin Q, Ji C, Yuan P, Chen L. Innovative Telerehabilitation Enhanced Care Programme (ITECP) in young and middle-aged patients with haemorrhagic stroke to improve exercise adherence: protocol of a multicentre randomised controlled trial. BMJ open. 2023 Dec 1;13(12):e072268.
Rossetto F, Mestanza Mattos FG, Gervasoni E, Germanotta M, Pavan A, Cattaneo D, Aprile I, Baglio F. Efficacy of telerehabilitation with digital and robotic tools for the continuity of care of people with chronic neurological disorders: The TELENEURO@ REHAB protocol for a randomized controlled trial. Digital Health. 2024 Mar;10:20552076241228928.
Proietti T, Nuckols K, Grupper J, de Lucena DS, Inirio B, Porazinski K, Wagner D, Cole T, Glover C, Mendelowitz S, Herman M. Combining soft robotics and telerehabilitation for improving motor function after stroke. Wearable Technologies. 2024 Jan;5:e1.
Saywell NL, Vandal AC, Mudge S, Hale L, Brown P, Feigin V, Hanger C, Taylor D. Telerehabilitation after stroke using readily available technology: a randomized controlled trial. Neurorehabilitation and neural repair. 2021 Jan;35(1):88-97.
Dodakian L, McKenzie AL, Le V, See J, Pearson-Fuhrhop K, Burke Quinlan E, Zhou RJ, Augsberger R, Tran XA, Friedman N, Reinkensmeyer DJ. A home-based telerehabilitation program for patients with stroke. Neurorehabilitation and neural repair. 2017 Oct;31(10-11):923-33.
Home-Based Virtual Reality Exergame Program after Stroke Rehabilitation for Patients with Stroke: A Study Protocol for a Multicenter, Randomized Controlled Trial.
Appleby E, Gill ST, Hayes LK, Walker TL, Walsh M, Kumar S. Effectiveness of telerehabilitation in the management of adults with stroke: A systematic review. PloS one. 2019 Nov 12;14(11):e0225150.
Chen J, Jin W, Zhang XX, Xu W, Liu XN, Ren CC. Telerehabilitation approaches for stroke patients: systematic review and meta-analysis of randomized controlled trials. Journal of Stroke and Cerebrovascular Diseases. 2015 Dec 1;24(12):2660-8.
Zhang Y, Jin Q, Ji C, Yuan P, Chen L. Innovative Telerehabilitation Enhanced Care Programme (ITECP) in young and middle-aged patients with haemorrhagic stroke to improve exercise adherence: protocol of a multicentre randomised controlled trial. BMJ open. 2023 Dec 1;13(12):e072268.
Chen J, Jin W, Dong WS, Jin Y, Qiao FL, Zhou YF, Ren CC. Effects of home-based telesupervising rehabilitation on physical function for stroke survivors with hemiplegia: a randomized controlled trial. American journal of physical medicine & rehabilitation. 2017 Mar 1;96(3):152-60.
Sharififar S, Ghasemi H, Geis C, Azari H, Adkins L, Speight B, Vincent HK. Telerehabilitation service impact on physical function and adherence compared to face‐to‐face rehabilitation in patients with stroke: A systematic review and meta‐analysis. PM&R. 2023 Dec;15(12):1654-72.
Hestetun-Mandrup AM, Toh ZA, Oh HX, He HG, Martinsen AC, Pikkarainen M. Effectiveness of digital home rehabilitation and supervision for stroke survivors: A systematic review and meta-analysis. Digital Health. 2024 Jun;10:20552076241256861.
Asano M, Tai BC, Yeo FY, Yen SC, Tay A, Ng YS, De Silva DA, Caves K, Chew E, Hoenig H, Koh GC. Home-based tele-rehabilitation presents comparable positive impact on self-reported functional outcomes as usual care: the Singapore tele-technology aided rehabilitation in stroke (STARS) randomised controlled trial. Journal of Telemedicine and Telecare. 2021 May;27(4):231-8.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Pakistan Journal of Rehabilitation

This work is licensed under a Creative Commons Attribution 4.0 International License.