Telerehabilitation approaches are equally as effective as conventional rehabilitation for stroke patients

Chen J, Jin W, Zhang XX, et al.  Les approches de téléréadaptation pour les patients qui ont subi un accident vasculaire cérébral: une revue systématique et méta-analyse d'essais contrôlés randomisés Journal of Stroke and Cerebrovascular Diseases. 2015 December:24(12):2660-2668.

Review questions

Does telerehabilitation (i.e., rehabilitation programs delivered remotely to patients in their homes with the assistance of information and communication technology) lead to improvements in daily living activity, motor function, quality of life, satisfaction and cost-effectiveness for stroke patients?

Background

Stroke survivors suffer from functional disability that can result in limitations in terms of quality of life and independence.

Organized systems of multidisciplinary care, such as stroke units, can be effective in reducing adverse outcomes, however, hospital care resources are limited in most regions. In addition, inconvenient transportation and costly rehabilitation programs delay timely access to care.

Diverse telerehabilitation programs may be a promising method to provide rehabilitation intervention strategies and support for disabled stroke patients living at home, by removing the need for transportation and substantial resources.

How the review was done

A detailed search of a number of electronic databases for studies published up to March 2015 was conducted. Studies that focused on rehabilitation interventions and assessments via telemedicine, telecommunication media and intervention programs, or that compared telerehabilitation with conventional rehabilitation, were included in the review.

A total of 2,587 studies were identified in searches, and 11 were included in the review after assessments for eligibility.

The authors did not acknowledge any funding sources for this review.

What the researchers found

The review found that telerehabilitation was not better at improving activities of daily living and motor function for stroke survivors, compared to conventional rehabilitation.

Few studies investigated secondary outcomes and all reported no changes in quality of life or satisfaction between telerehabilitation and conventional rehabilitation.

Telerehabilitation may be more cost-effective and result in lower overall expenses compared to conventional rehabilitation. However, the evidence reporting this was very limited.

Conclusion

The review found that telerehabilitation is equally as effective as conventional rehabilitation in improving activities of daily living, motor function, quality of life and satisfaction in stroke survivors. To some extent, telerehabilitation may reduce the cost of rehabilitation in certain scenarios. Further research in this area is needed to extend the evidence base and find any beneficial effects of telerehabilitation.