Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Nov 12;14(11):e0225150.
doi: 10.1371/journal.pone.0225150. eCollection 2019.

Effectiveness of telerehabilitation in the management of adults with stroke: A systematic review

Emma Appleby  1 , Sophie Taylor Gill  1 , Lucinda Kate Hayes  1 , Tessa Lauren Walker  1 , Matt Walsh  1 , Saravana Kumar  1
Affiliations

Effectiveness of telerehabilitation in the management of adults with stroke: A systematic review

Emma Appleby et al. PLoS One. .

Abstract

Background: Stroke is a leading cause of mortality and morbidity and access to timely rehabilitation can reduce morbidity and help patients to return to normal life. Telerehabilitation can deliver rehabilitation services with the use of technology to increase patient options, deliver services more efficiently and overcome geographical barriers to healthcare access. Despite its popularity, there is conflicting evidence for its effectiveness. Therefore, the aim of this systematic review was to update the current evidence base on the effectiveness of telerehabilitation for stroke.

Methods: A systematic search of databases (Medline Ovid; Embase; Emcare; Scopus; The Cochrane Library; PEDro; OTSeeker) was conducted in April 2018 (updated in October 2018). This review was conducted and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and methodology registered with PROSPERO (CRD42018090445). A modified McMaster critical appraisal tool for quantitative studies was used to assess the methodological quality of the included studies. Given the heterogeneity of the included studies, a descriptive synthesis was conducted.

Results: Out of 1868 studies, 13 randomised controlled trials met the inclusion criteria. A diverse range of interventions were delivered through a variety of telerehabilitation systems and the effectiveness measured through a myriad of outcome measures. Summarised findings from the heterogeneous evidence base indicate that telerehabilitation may have a positive impact on a range of primary and secondary outcomes. However, despite these positive findings, the current evidence lacks clarity and uniformity in terms of intervention parameters and measurement of outcomes, which limits broader application of these results.

Discussion: Telerehabilitation, as an alternate form of rehabilitation for people with stroke, shows potential. However, due to methodological and practical concerns, an unequivocal recommendation cannot be made. Findings from this review may inform future policies and practices regarding the use of telerehabilitation for stroke patients.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. PRISMA flowchart.
See this image and copyright information in PMC

References

    1. Donnan G, Fisher M, Macleod M, Davis S. Stroke. Lancet. 2008. May 10; 371(9624):1612–23. 10.1016/S0140-6736(08)60694-7 - DOI - PubMed
    1. Stroke Foundation [Internet]. Melbourne VIC: Stroke Foundation; c2018 [cited 2018 March 13]. No postcode untouched–Stroke in Australia 2017. Available at http://maps.strokefoundation.com.au/wp-content/themes/dlstroke/downloads...
    1. Australian Institute of Health and Welfare [Internet]. Canberra ACT: AIHW; c2019 [cited 2019 Oct 4]. Australia’s health 2018. Available from: https://www.aihw.gov.au/getmedia/7c42913d-295f-4bc9-9c24-4e44eff4a04a/ai....
    1. 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. J Stroke Cerebrovasc Dis. 2015. December 1;24(12):2660–8. 10.1016/j.jstrokecerebrovasdis.2015.09.014 - DOI - PubMed
    1. Stroke Foundation [Internet]. Melbourne VIC: Stroke Foundation; c2018. [cited 2018 March 7]. National Stroke Audit–Acute Services Clinical Audit Report 2017. Available from https://informme.org.au/en/stroke-data/Acute-audits

Publication types