Recuperación funcional del brazo parético mediante la Terapia de Movimiento Inducido por Restricción en modalidad remota versus presencial: Un estudio en pacientes post- ictus de nivel socioeconómico bajo o medio.

Abstract

Background: Evidence suggests that low socioeconomic status (SES), being associated with lower digital alphabetization, may affect post-stroke telerehabilitation outcomes. Objectives: To compare in patients of low and medium SES (1) the functional recovery of the paretic arm when applying Modified Constraint-Induced Movement Therapy (CIMTm) in remote versus face-to-face modality and (2) to examine the role of patient's experience with the remote modality in this recovery. Material and methods: Randomized clinical trial composed of two intervention groups exposed to TeleCIMTm (n=22) and CIMTm (n=26). Assestment of upper limb function in the paretic arm was done at baseline (T1), at the end of de intervention, and one month later. Additionally, in T2 a survey was applied for measure the user experience on the remote modality. Results: Following the intervention (T2) it was found that both modalities increased the function of the paretic arm. However, when comparing data by sex in the TeleCIMTm group, men increased function to a greater extent, while in the CIMTm group there were no significant differences by sex. At the follow-up assessment (T3), participants continued to improve function regardless of modality and gender. In relation to the user experience, women reported a greater frequency of unfavorable events. Conclusions: The effectiveness of TeleCIMTm is comparable to the in-person version. The digital skills of patients with low and medium SES seem to be sufficient to benefit functionally from TeleCIMTm if optimal contextual conditions are guaranteed for carrying out the sessions. Key words: telerehabilitation, stroke, upper extremity (arm), occupational therapy, physiotherapy