Page 60 - JCTR-11-3

Journal of Clinical and
Translational Research Telerehabilitation after stroke

Table 2. Risk of bias using the physiotherapy evidence database (PEDro) scale
PEDro scale questions Studies included in the review
Emmerson et al. Redzuan et al. Asano et al. Chen et al.
(2017) 10 (2012) 13 (2019) 14 (2020) 15
Subjects were randomly allocated to groups (in a crossover study, subjects were Yes (+1) Yes (+1) Yes (+1) Yes (+1)
randomly allocated an order in which treatments were received)
Allocation was concealed Yes (+1) No (0) Yes (+1) Yes (+1)
The groups were similar at baseline regarding the most important prognostic Yes (+1) No (0) Yes (+1) Yes (+1)
indicators
There was blinding of all subjects No (0) No (0) No (0) No (0)
There was a blinding of all therapists who administered the therapy No (0) No (0) No (0) No (0)
There was blinding of all assessors who measured at least one key outcome Yes (+1) No (0) No (0) Yes (+1)
Measures of at least one key outcome were obtained from more than 85% of the Yes (+1) No (0) Yes (+1) Yes (+1)
subjects initially allocated to groups
All subjects for whom outcome measures were available received the treatment or No (0) No (0) Yes (+1) Yes (+1)
control condition as allocated or, where this was not the case, data for at least one key
outcome was analyzed by “intention to treat”
The results of between-group statistical comparisons are reported for at least one key Yes (+1) Yes (+1) Yes (+1) Yes (+1)
outcome
The study provides both point measures and measures of variability for at least one Yes (+1) Yes (+1) Yes (+1) Yes (+1)
key outcome
Total score 7/10 3/10 7/10 8/10

Chen et al. explored the impact of a 12-week home- Personalized feedback plays a crucial role in enhancing
15
based motor telerehabilitation program for subcortical stroke the efficacy of home-based programs. Both Emmerson
patients. In the study, 52 individuals were divided into a et al. and Chen et al. incorporated therapist feedback,
10
15
telerehabilitation group (supervised videoconference training) which has the potential to increase engagement and
and a control group (in-person outpatient rehabilitation). adherence. However, despite this personalization, the
The telerehabilitation group displayed significant gains in results did not consistently exhibit significant advantages
Fugl-Meyer Assessment (FMA) scores (p=0.011), indicating over traditional methods. This suggests that while
improved motor function, but there were no significant technology offers convenience, the quality of interaction
differences in modified Barthel index (MBI) scores. between patients and therapists needs further refinement
These findings suggest that rehabilitation programs to optimize outcomes in home-based stroke rehabilitation.
incorporating video-guided exercises can yield results Although technological advancements such as video-
comparable to face-to-face therapy, offering a safe and guided exercises and automated reminders have been
cost-effective alternative for stroke survivors. Functional integrated into home rehabilitation programs, the reviewed
improvements were observed across all ICF domains, studies suggest that these innovations alone may not
though most studies focused on activity as the primary significantly improve outcomes. For instance, Emmerson
outcome. Future research exploring changes in social et al. and Redzuan et al. found no significant differences
10
13
participation and functional outcomes may provide a in rehabilitation success compared to traditional methods.
deeper understanding of clinical progression. Video-based This suggests that factors beyond the mode of delivery, such
approaches could potentially reduce social disparities and as intensity, engagement, and the individualized nature
enhance access to comprehensive stroke care. of the interventions, play a crucial role in determining
The limited number of RCTs in this area highlights the effectiveness of home-based stroke rehabilitation
the need for further studies with clear, high-quality programs. Future studies should explore how to optimize
methodological designs to ensure their findings can be the interaction between technology, patient engagement,
effectively translated into clinical practice. Variations in and therapist involvement in remote settings.
intervention duration and intensity may have influenced The lack of significant differences between
the results, as shorter interventions have less impact telerehabilitation and in-person therapies raises
10
compared to longer programs. 13-15 the potential of both approaches to deliver effective

Volume 11 Issue 3 (2025) 54 doi: 10.36922/jctr.8360