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

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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 10 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 two 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), the Netherlands (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 and 12 weeks. We found that there were 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.