Page 57 - JCTR-11-3

Journal of Clinical and
Translational Research Telerehabilitation after stroke

1. Introduction analyzed in a context that considers the interaction between
their health condition, body structures and functions,
Stroke is considered a global health problem and a disabling activity performance, social participation, and contextual
1
condition. According to the 2013 National Health Survey, factors that may facilitate or hinder their functionality. 11,12
there are more than two million stroke survivors in The main objective of this review is to describe functional
Brazil, approximately 568,000 of whom live with severe improvements in the domains of structure and function,
disability. This comorbidity is more prevalent in the elderly activity, and participation promoted through video-
population, those living in urban areas, and those with demonstrated exercises. As a secondary objective, the
lower educational levels, and factors such as obesity and assessment instruments used in the studies will be listed.
physical inactivity increase the risk of its occurrence, raising
2,3
concerns about the increase in the number of cases. In 2. Methods
addition, lifestyle changes have contributed to the rising
incidence among the younger population, especially due to This study is characterized as a systematic review,
the association with hypertension. As a chronic condition with the search conducted between October 2008 and
4
that results in functional deficits, individuals affected by December 2024 across three online databases: BVS
stroke require ongoing care, even after hospital discharge. 5 (Virtual Health Library), PubMed (National Library of
Medicine and National Institutes of Health), and Web
Rehabilitation treatment, typically provided in
specialized units, aims to reduce secondary complications, of Science. To facilitate the search for evidence, the
following question was formulated (PICO strategy):
promote recovery of bodily functions, increase “What functional improvements can video-demonstrated
independence in daily living activities, and contribute to exercises promote in post-stroke individuals?”; where
social reintegration. Nonetheless, various challenges, the population consisted of individuals post-stroke, the
5,6
such as the high cost of rehabilitation, insufficient awareness intervention involved exercise programs demonstrated
of its benefits, and limited access to transportation, create
substantial obstacles to effective patient care. To address through audiovisual means, compared to other physical
7
these issues, several care models have been developed to therapy interventions, and the outcomes were measured
better align with the needs and expectations of patients, in the domains of structure and function, activity, and
caregivers, and healthcare providers. In the case of participation according to the ICF.
stroke survivors, many express a preference for exercises Articles published in English between 2008 and 2024
demonstrated to them, as the visual presentation helps were included; randomized clinical trials (RCTs) with
in the correct execution of movements, providing greater samples consisting of post-stroke patients allocated into
safety for both the patient and the caregiver. 8 two groups, with the experimental group receiving only
It is important to note that impaired balance can harm video-based exercises as the intervention, were selected.
the autonomy and quality of life of both individuals who Articles not available in full, duplicate articles across
have suffered a stroke and their caregivers. Proprioceptive databases, those not addressing the core topic, as well as
training has proven to be an effective strategy for monographs and theses, were excluded.
recovering motor skills and preventing falls, but it requires The search was conducted by two blinded researchers
hospitalization or daily in-person sessions, which can using the following descriptors and their synonyms:
limit access for many patients. Thus, video-assisted “Neurological Rehabilitation” and “Stroke Rehabilitation,”
9
rehabilitation has proven to be a promising alternative, as combined with “Instructional Films and Videos,” “Video-
it allows stroke survivors to follow targeted rehabilitation Audio Media,” and “Telerehabilitation,” excluding those
strategies in the comfort of their homes, contributing to related to virtual reality. All terms are registered in the
the continuity of treatment, in addition to providing better National Library of Medicine’s controlled vocabulary
conditions for access and adherence to the desired therapy. thesaurus (MeSH) and the Health Sciences Descriptors
Exercise demonstrations through video can offer (DeCS). The Boolean operator “OR” was used between
even greater precision, allowing for detailed monitoring the descriptors and their synonyms, while the Boolean
of movements, with the possibility to revisit the video as operator “AND” was used between different descriptors.
many times as needed for effective learning. Studying the Articles were initially screened by reading titles and
10
functional outcomes of video-based therapy can provide a abstracts, followed by an examination of full texts. After
deeper understanding of home rehabilitation and its effects each of these steps, a third researcher was consulted to
on the patient, caregiver, and even healthcare professionals. resolve discrepancies between results and decide whether
The International Classification of Functioning (ICF), to retain or exclude articles. This rigorous analysis allowed
Disability, and Health suggests that individuals should be the identification of relevant studies, despite challenges

Volume 11 Issue 3 (2025) 51 doi: 10.36922/jctr.8360