Effectiveness of Telerehabilitation Versus Conventional Rehabilitation on Motor Function and Activities of Daily Living After Stroke: A Systematic Review of Randomized Controlled Trials.

In 30 seconds

This systematic review of randomized controlled trials compared telerehabilitation with conventional physiotherapy for motor function and activities of daily living after stroke. Four trials included 226 randomized participants. In one dose-matched trial, home telerehabilitation was noninferior for change in Fugl-Meyer score, with an adjusted difference of 0.06 points (95% CI -2.14 to 2.26; p = .96). Other trials reported mixed results, and the review judged certainty very low for both motor and daily-living outcomes. Overall, the evidence did not establish general superiority over equivalent in-person rehabilitation.

Key findings

• A dose-matched trial found noninferiority for Fugl-Meyer change: adjusted difference 0.06 points (95% CI -2.14 to 2.26; p = .96).
• Two trials reported no significant between-group difference in FMA-UE or Modified Barthel Index trajectory.
• One trial found group-by-time interactions for FM-UE (p = .001) and FIM (p = .006), but telerehabilitation was added to home exercise and was not dose matched.
• Certainty was very low for motor and activities-of-daily-living outcomes; two trials had some risk-of-bias concerns.

Why it matters

Remote rehabilitation may offer a way to deliver physiotherapy after stroke, and the dose-matched trial supports comparable arm motor recovery in that setting. However, mixed findings and very low certainty mean the evidence cannot establish that telerehabilitation is generally better than equivalent in-person care. Comparisons that align treatment content and dose are important for interpreting effectiveness.

What to keep in mind

Only four trials with 226 randomized participants were included. The review reports inconsistency, indirectness, imprecision, and risk-of-bias concerns, and some comparisons were not dose matched.