Page 62 - JCTR-11-3

Journal of Clinical and
Translational Research Telerehabilitation after stroke

correlation. Like the MBI, the WMFT was used to assess replication in future studies. However, it indicates the
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the activity domain. However, the scale determines the viability of using video exercises as a way of learning and
10
ability to move only the upper limbs, analyzing the quality, monitoring stroke patients who have functional deficits in
speed, and strength of execution during the activities the upper limb. 10,30-33
tested. Thus, it also includes the structure and function One of the key findings of this review is the potential
domains. 20
for video-based interventions to reduce the barriers to
There is a tendency to use assessment instruments accessing rehabilitation, particularly for individuals living
that address the activity domain, as they facilitate the in rural or underserved areas. The use of video exercises
establishment of relationships with functionality and facilitates adherence to treatment and provides flexibility,
clinical reality. 10,13,21 For example, a deficit in a structure is allowing patients to follow their rehabilitation schedules
often only noticed when it interferes with the execution of without the need for frequent in-person visits. This approach
a task or social interaction. However, it is recommended may be especially beneficial in settings where healthcare
that instruments should be chosen carefully. For the professionals are scarce, ensuring that patients still have
assessment of people with mild and moderate disabilities, access to structured rehabilitation programs. The ability
investigation of instrumental activities and more complex to access rehabilitation exercises at home also mitigates
tasks is recommended, avoiding the ceiling effect that the logistical challenges of travel, potentially increasing
is common when examining basic activities. While adherence to prescribed exercise regimens, thereby leading
instruments that measure structure and function are the to better outcomes for stroke patients. This aspect of home-
most capable of providing a rich comparison between based telerehabilitation is an advantage that may improve
pre- and post-intervention results, the measurement of stroke rehabilitation accessibility, especially when coupled
participation still needs to be further researched and has with ongoing support from healthcare providers.
been used as a secondary outcome. 21
In addition, the positive correlation between the use of
Attention and learning deficits are also analyzed with video-guided exercises and improved functional outcomes,
recurrence as a secondary outcome in interventions with as observed in some studies, highlights the potential of
exercise programs, but they have a great influence on these interventions to support neurological recovery. The
the rehabilitation process. Attention is essential for the findings from Chen et al., which indicated a link between
15
retention, organization, and execution of information and neural plasticity and recovery of function, provide a
is indispensable for the learning process. Video exercises compelling argument for the use of video-based therapies
22
contribute to this process, as they provoke the need for in rehabilitation programs. These results suggest that
observation to perform the task, expanding the individual’s home-based rehabilitation, when delivered through video-
repertoire of activities through mistakes and successes, guided exercises, might not only support motor function
in addition to generating new motor patterns. 21,22 This but also contribute to neuroplastic changes that are crucial
observe-execute sequence is repeated in other therapeutic for recovery after stroke. Further studies investigating
approaches, such as in action observation therapy, and the neurophysiological underpinnings of video-based
is justified by the activation of mirror neurons after the rehabilitation would be valuable in understanding the full
execution or observation of a task. 23-28 extent of these interventions’ benefits on neural recovery.
It is important to understand that stroke causes several The ability of video interventions to enhance caregiver
consequences for the individual and affects their quality involvement is another important aspect highlighted
of life and functionality. 11,24,29 Considering the relationship by the studies reviewed. As caregivers play a critical role
between the elements that make up the ICF when in the rehabilitation process, especially in home-based
investigating interventions demonstrated by video can settings, the educational component embedded in video
enable a clear organization of information and facilitate interventions can empower caregivers with the necessary
application in clinical practice, in addition to contributing skills and confidence to assist in the rehabilitation process.
to the development of strategies aimed at comprehensive This is particularly important in post-stroke recovery,
rehabilitation. Home-based approaches through videos where the patient’s functional abilities can fluctuate, and
allow patients to carry out rehabilitation comfortably, caregivers may face challenges in providing appropriate
overcoming some barriers that could interfere with their care. As reported by Redzuan et al., the reduction of
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adherence to treatment. 7,10,13 caregiver burden is closely linked to improved patient
Notably, one of the articles included in this review outcomes, underscoring the importance of incorporating
presents a confusing methodology that makes the caregiver training into rehabilitation programs. Video-
intervention difficult to understand and hinders its based interventions provide an effective platform for

Volume 11 Issue 3 (2025) 56 doi: 10.36922/jctr.8360