Page 61 - JCTR-11-3

Journal of Clinical and
Translational Research Telerehabilitation after stroke

rehabilitation. However, the absence of marked also be considered, as there may be additional costs for
improvements in functional outcomes, such as the BI equipment, travel, and training of professionals. 13
and FMA, raises questions about the sensitivity of these As one of the therapeutic strategies that can be delivered
assessments to detect subtle but clinically meaningful at home, audiovisual resources are capable of providing
changes. Further research could benefit from using greater precision in movements, reinforcing correct
more specific or comprehensive outcome measures exercise techniques, improving caregivers’ care skills, and
to capture a broader range of functional and quality- acting as reminders to maintain regular therapy. 10,13 This
of-life improvements. This would allow for a deeper implies increased caregiver confidence during activities
understanding of how different rehabilitation models and increased therapy safety.
impact long-term recovery and whether combining
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elements of both telehealth and traditional therapies could Such benefits were verified by Emmerson et al.,
optimize post-stroke rehabilitation. 13,15 who identified the use of videos in home rehabilitation
programs as viable and safe, resulting in improvements
A common limitation across these studies is the reliance in upper limb function. The use of this technology
on relatively short-term follow-up periods (1 – 3 months). optimizes professional performance by allowing greater
While these studies provide valuable insights into ease in adapting the exercise protocol throughout therapy,
immediate and short-term rehabilitation outcomes, the with the development of an intensity progression being
long-term effects of home-based rehabilitation programs recommended to avoid system accommodation. 10,13
remain underexplored. Longitudinal studies tracking
patients’ progress over extended periods are needed to Individuals and caregivers experience worry and
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assess the sustainability of functional improvements, anxiety after a cerebrovascular event. Evidence indicates
long-term independence, and the overall impact of these that interventions that prepare caregivers for the new
interventions on stroke survivors’ quality of life. These routine can alleviate feelings of burden and psychological
insights are essential to refining home rehabilitation stress. 16,17 It is also recommended that caregivers’
programs to ensure that they improve both short-term knowledge and skills should be assessed before therapy to
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recovery and long-term health benefits. include their needs in the therapeutic planning. Redzuan
et al. pointed out the reduction of burden on caregivers
13
4. Discussion as one of the factors responsible for the better performance
This review provides a state-of-the-art review of the of activities of daily living in individuals in the acute phase
evidence on improvements in the functionality of after stroke who received exercise instructions via video.
individuals who have suffered a stroke after performing The results presented also demonstrate the similarity of
exercises demonstrated through video. Despite the small telerehabilitation with face-to-face therapy regarding the
number of articles found, there was a consensus that the time spent performing exercises, as discussed by Asano
14
use of video-based exercises is capable of achieving results et al. In addition, the implementation of this practice
similar to conventional therapy, performed in person by in the rehabilitation of stroke patients may be a viable
health professionals. Therefore, the choice to use this type alternative to reduce transportation costs with hours of
of assistive technology is justified because it allows for a face-to-face supervision by health professionals. Another
greater scope of rehabilitation programs, considering interesting finding was seen in Chen et al., who, in
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that many health services have a demand greater than the addition to research focused on motor function and degree
number of professionals available, in addition to offering of independence, also evaluated imaging biomarkers of
patients and their caregivers greater convenience and neurological function to analyze and compare neural
ease. 10,13 plasticity with recovery of function, obtaining a positive
Rehabilitation in the home environment has been correlation of findings, thereby suggesting further studies
considered useful for improving the functional capacity in this perspective.
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of post-stroke individuals in a less costly manner for In the study by Redzuan et al., functional improvements
the patient and with the benefit of alleviating stress for were assessed by a difference of 30 or more points in the
caregivers. However, its indication should be judicious, as MBI after 3 months of intervention. The elements of the
1
it depends on personal conditions, such as educational level, MBI present a moderate-to-strong correlation with the
age, and severity of the stroke, and is not recommended ICF, except for the items “anal continence” and “bathing,”
when the caregiver is absent or has little commitment and suggesting that it is an appropriate instrument to assist in
if there is no communication with the health team. In the application of the ICF. However, further studies with a
1,13
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addition, the perspective of the health provider should larger sample size are warranted to better substantiate this
Volume 11 Issue 3 (2025) 55 doi: 10.36922/jctr.8360