Effectiveness of telerehabilitation on quality of life in stroke survivors: a systematic review and meta - analysis

Gebrye, Tadesse ORCID: https://orcid.org/0000-0001-7976-2013, Mbada, Chidozie ORCID: https://orcid.org/0000-0003-3666-7432, Fatoye, Francis ORCID: https://orcid.org/0000-0002-3502-3953 and Anazodo, Cosmas (2024) Effectiveness of telerehabilitation on quality of life in stroke survivors: a systematic review and meta - analysis. Physical Therapy Reviews, 29 (4). pp. 187-196. ISSN 1083-3196

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Abstract

Background: Recent advances in technology have made possible the delivery of health services to patients remotely, and telerehabilitation for stroke survivors has emerged as a promising intervention. This systematic review assessed the clinical effectiveness of telerehabilitation (TR) programmes on quality of life (QoL) of stroke survivor compared to standard care. Methods: MEDLINE, CINAHL, AMED, Web of Science and Scopus databases were searched from inception to 10th of June 2022. Studies were considered eligible for inclusion if they fulfilled the following criteria: assessed the efficacy of different telerehabilitation models in poststroke patients, employed randomised controlled trial, and non-randomised design, stroke survivor adults age ≥ 18 years, health related quality of life outcome, and full text available. Data were extracted by 2 independent researchers. Risk of bias was assessed by the Cochrane Handbook for Systematic Reviews of Interventions. A meta-analysis was performed among trials presenting with similar clinical characteristics. Results: A total of 11 eligible studies that met the inclusion criteria were included in the review. These studies were conducted in Brazil (n=1), Italy (n=2), Netherland (n=1), South Korea (n=1), Taiwan (n=1), United Kingdom (n=1) and United States (n=4) between 2004 and 2020. Except for blinding of participants to study group allocation, all the studies were (> 50%) at low risk of bias to considering adequate sequence generation, allocation concealment, blinding of trial personnel or outcome assessors, evaluation of incomplete outcome data, and lack of selective reporting. The meta-analysis (n = 5) included 306 individuals with duration of follow up ranged between 4 weeks and 12 weeks. We found that there was no statistically significant difference (SMD = 0.089, confidence interval (CI) 95% = -0.184 to 0.362, p = 0.522) for Stroke Impact Scale between the interventions and the control. Conclusion: The review provides evidence for the effectiveness of TR interventions to improve the QoL of stroke survivors in a short-term. Further research studies are required to examine the effectiveness of TR interventions for stroke survivors in a long-term follow-up.