Development Of Future Measures Research Articles

Concept Analysis of Psychosocial Distress Among African American and Latine Men Who Have Sex With Men: Implications for HIV Care.

The aim of this study is to provide conceptual clarity on psychosocial distress among African American and Latine men who have sex with men living with human immunodeficiency virus. Concept analysis. The 8-step Walker and Avant framework guided the concept analysis of psychosocial distress tailored to this patient population. A literature review was conducted using the research databases PubMed/Medline, PsycINFO, the Cumulated Index of Nursing and Allied Health Literature and Scopus with the selected search terms. A total of 7 articles were retrieved and analysed to explicate the antecedents, attributes, and consequences of psychosocial distress in this population. Four cases were developed to further clarify the concept of psychosocial distress; a model case, borderline case, related case and contrary case. As experienced by African American and Latine men who have sex with men living with human immunodeficiency virus, psychosocial distress is defined as a state of suffering due to uncontrollable structural and/or social factors that threaten the individual's existence and/or livelihood based on their social identity as a racial/ethnic, sexual minority. The concept analysis of psychosocial distress can be useful to guide future theory and measurement development to enhance disease-specific and general health outcomes for sexual and racial/ethnic minoritised men who have sex with men. Not applicable. No patient or public contribution.

Assessment and Prediction of Health and Agricultural Impact from Combined PM2.5 and O3 Pollution in China

Combined PM2.5 and O3 pollution in China has caused negative health impacts on residents and reduced crop yields. The quantitative assessment and prediction of these impacts could provide a scientific basis for policy development. This study assessed the nationwide premature mortality, health effects, and crop damage attributable to PM2.5 and O3 pollution in 2019, and projected the associated health and agricultural losses under a business-as-usual (BAU) scenario for 2025. The economic benefits of improving air quality under different policy scenarios, including the 14th Five-Year Plan (FFP), Secondary Standard Limit (SSL), and Primary Standard Limit (PSL), were also explored. The results showed PM2.5 pollution in 2019 resulted in 246,000 all-cause premature deaths and the economic health loss was RMB 196.509 billion. Similarly, O3 pollution caused 186,300 premature deaths and the economic health loss was RMB 155.807 billion. O3 pollution has led to a loss of 28.5241 million tonnes of crop production and an economic loss of RMB 62.268 billion. Compared with 2019, the avoidable premature deaths from PM2.5 under different scenarios in 2025 were 50,600, 43,000, and 200,300 cases, respectively, exceeding the number of avoided premature deaths from O3 pollution. Compared with the BAU, reducing PM2.5 under different scenarios could generate economic benefits of RMB 70.178 billion, RMB 60.916 billion, and RMB 229.268 billion. Furthermore, the FFP scenario outperformed the SSL in mitigating winter wheat production losses caused by O3 pollution. These results provide important scientific support for the development and evaluation of future comprehensive pollution control measures for PM2.5 and O3.

Features and evaluations of organizational support provided by occupational health nurses in private practice for the implementation of sustainable health and productivity management in medium-sized enterprises

This study aimed to clarify the features and evaluations of the organizational support provided by occupational health nurses (OHNs) in private practice to promote sustainable health and productivity management (HPM) in medium-sized enterprises. Corporate managers and employees of four enterprises with fewer than 300 employees received support from an experienced OHN in private practice through five support sessions per company, primarily targeting company managers. The OHNs documented their support steps and evaluations. After completing the support process, we conducted semi-structured interviews with company managers and OHNs to evaluate the support provided by the OHNs. The support processes were organized for each company according to an analytical framework based on the consolidated framework for implementation research; the support features of OHNs were extracted. The evaluations of the support provided by OHNs from the perspective of company personnel were categorized using content analysis. Six features of support by OHNs for the promotion of HPM were extracted, including clarifying corporate needs while focusing on relationships of trust with company representatives, providing appropriate health information, and introducing external resources to facilitate independent and continuous efforts in the company to promote sustainable HPM. The managers' evaluations of the support provided by the OHNs included the following six categories: 1) identified and recognized current internal health issues; 2) received specific assistance tailored to the company; 3) gained an opportunity to work on health promotion measures; 4) considered the development and continuation of future health promotion measures; 5) learned about the existence of OHNs as easy to consult with; and 6) identified aspects of support from OHNs that were different from what they expected. This study clarified the features and evaluations of the support provided by OHNs in private practice in medium-sized enterprises for the promotion of HPM. Our findings suggest that the involvement of OHNs in private practice may increase the number of medium-sized enterprises that can autonomously commit themselves to HPM in a sustainable manner.

Mendelian randomization analysis of psoriasis and psoriatic arthritis associated with risks of ulcerative colitis.

This study is designed to explore the potential causal relationship between psoriasis and psoriatic arthritis (PsA) while investigating the genetic basis shared by these inflammatory diseases. Significant single nucleotide polymorphisms (SNPs) associated with UC, psoriasis, and PsA were selected as genetic instrumental variables using Genome-Wide Association Study (GWAS) datasets. Additionally, Mendelian randomization (MR) methods, including inverse-variance weighting (IVW), MR-Egger regression, and Weighted Median (WME), were utilized to evaluate the causal relationships between these diseases. Moreover, sensitivity analysis and heterogeneity testing were conducted to validate the stability of the results. A total of 123 significant SNPs associated with psoriasis, PsA, and UC were identified as genetic instrumental variables based on GWAS datasets. The analysis revealed a 36% increased risk of UC with psoriasis (odds ratio [OR]=1.350, 95% confidence interval [CI]=1.065-1.729, P=0.012) and a 32.9% increased risk of UC with PsA (OR=1.329, 95% CI=1.176-1.592, P<0.001). Further analysis showed a 43.5% increased risk of psoriasis with UC (OR=1.435, 95% CI=1.274-1.831, P<0.001) and a 45.8% increased risk of PsA with UC (OR=1.458, 95% CI=1.166-1.822, P=0.0013). In addition, sensitivity analysis and heterogeneity testing demonstrated the high stability of these results. Particularly, neither MR-Egger regression analysis nor leave-one-out analysis revealed significant heterogeneity or pleiotropy bias, indicating the reliability of these causal estimates. Moreover, the use of the MR-PRESSO further confirmed the positive correlation between psoriasis and UC, and the corrected estimates remained consistent with IVW analysis results after excluding potential outlier SNPs, enhancing the credibility of the analysis. This study strengthens the understanding of the genetic and causal relationships among UC, psoriasis, and PsA through GWAS and MR methods, revealing the genetic basis they may share. These findings not only provide a novel perspective on the comorbidity mechanisms of these diseases but also offer a valuable reference for the development of future treatment strategies and intervention measures.

Assessing social connection for long-term care home residents: A scoping review of measure content.

Social connection comprises distinct but interrelated aspects describing how individuals connect to each other. Various measures have assessed multiple aspects of social connection in long-term care (LTC) home populations, but they use inconsistent terminology, making it unclear what aspects are measured. This scoping review describes how social connection is assessed by measures that have been used in LTC home residents. This review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Two systematic literature searches combining search terms for social connection AND LTC home residents AND measurement properties were conducted in eight electronic databases from inception to April 2022. Included studies reported the development or psychometric testing of measures which assessed social connection in LTC home residents. A content analysis with a deductive-inductive approach was used to analyze the measures' content and an adapted Framework Method was used for data management. Findings report each measure's items and the assessed aspects of social connection. Dementia and non-dementia-specific measures had content, administration, and scoring compared. From 8753 records, 58 studies reporting on 14 dementia-specific and 28 non-dementia-specific social connection measures were identified, including complete measures, subscales, and single items. These measures assessed social network (52.4%), social isolation (11.9%), social interaction (47.6%), social engagement (31.0%), social support (33.3%), social connectedness (21.4%), and loneliness (9.5%). A total of 27 (64.3%) of the measures included more than one aspect of social connection. Dementia-specific measures most often assessed social interaction whereas non-dementia-specific measures most often assessed social network, social interaction, and social support. Dementia-specific measures typically relied on a proxy response, whereas non-dementia-specific measures more often used self-report. Existing social connection measures in LTC home settings operationalize seven aspects of social connection and differ according to the target population (dementia or non-dementia-specific). These findings will inform future measure selection and development. Social connection is important to long-term care (LTC) home residents' quality of life.Social connection has been assessed by quantifying/describing relationships.Existing measures usually assess more than one aspect of social connection.These aspects cover several interlinked observed or experienced domains.Dementia and non-dementia-specific measures differ in assessing social connection.

Patient-reported outcome and experience domains for diagnostic excellence: a scoping review to inform future measure development

Purpose“Diagnostic excellence,” as a relatively new construct centered on the diagnostic process and its health-related outcomes, can be refined by patient reporting and its measurement. We aimed to explore the scope of patient-reported outcome (PRO) and patient-reported experience (PRE) domains that are diagnostically relevant, regardless of the future diagnosed condition, and to review the state of measurement of these patient-reported domains.MethodsWe conducted an exploratory analysis to identify these domains by employing a scoping review supplemented with internal expert consultations, 24-member international expert convening, additional environmental scans, and the validation of the domains’ diagnostic relevance via mapping these onto patient diagnostic journeys. We created a narrative bibliography of the domains illustrating them with existing measurement examples.ResultsWe identified 41 diagnostically relevant PRO and PRE domains. We classified 10 domains as PRO, 28 as PRE, and three as mixed PRO/PRE. Among these domains, 19 were captured in existing instruments, and 20 were captured only in qualitative studies. Two domains were conceptualized during this exploratory analysis with no examples identified of capturing these domains. For 27 domains, patients and care partners report on a specific encounter; for 14 domains, reporting relates to an entire diagnostic journey over time, which presents particular measurement opportunities and challenges.ConclusionThe multitude of PRO and PRE domains, if measured rigorously, would allow the diagnostic excellence construct to evolve further and in a manner that is patient-centered, prospectively focused, and concentrates on effectiveness and efficiency of diagnostic care on patients’ well-being.

American Academy of Orthopaedic Surgeons Clinical Practice Guideline Summary Management of Osteoarthritis of the Hip.

The Management of Osteoarthritis (OA) of the Hip Evidence-Based Clinical Practice Guideline is based on a systematic review of published studies examining the treatment of OA of the hip in adults (aged 18 years and older). Based on the best current available evidence, this guideline contains eight recommendations and nine options to assist orthopaedic surgeons and all qualified physicians managing patients who have been diagnosed by a trained healthcare provider with OA of the hip and are currently undergoing treatment. It is also intended to serve as an information resource for professional healthcare practitioners and developers of practice guidelines and recommendations. In addition to providing pragmatic practice recommendations, this guideline also highlights gaps in the literature and informs areas for future research and quality measure development.

Exploring barriers to influenza vaccine uptake and recommendation among healthcare providers in the community in China: A qualitative study

ABSTRACT Healthcare providers (HCPs) are recommended for priority influenza vaccination due to their high risk of contracting influenza. HCPs greatly aid in targeted population immunization campaigns. Therefore, understanding the factors that influence HCPs’ decisions to get vaccinated and to recommend influenza vaccination is essential. However, there currently needs to be more evidence on this topic in China. Qualitative interviews using a semi-structured interview method were conducted with 180 HCPs from urban community hospitals and town hospitals in four cities in Shandong Province during August 2023. The interview content was analyzed using thematic analysis to identify the variables impacting the vaccination and recommendation practices of HCPs, as well as their suggestions for improving vaccination services. The results will help support the future development of precise intervention measures as well as focused education and training.

The Musculoskeletal Tumor Society Clinical Practice Guideline on the Management of Metastatic Humeral Disease.

Management of Metastatic Humeral Disease is based on a systematic review of published studies surrounding the management of metastatic disease, multiple myeloma, and lymphoma limited to the humerus. This guideline contains seven action statements to assist orthopaedic surgeons, orthopaedic oncologists, physicians, and any other qualified healthcare professionals involved in the surgical management of metastatic disease of the humerus. It is also intended to serve as an information resource for decision makers, researchers, and developers of clinical practice guidelines. In addition to providing pragmatic practice recommendations, this guideline also highlights gaps in the literature and informs areas for future research and quality measure development. This guideline has been endorsed by the American Academy of Orthopaedic Surgeons.

Psychological experience of university students during prolonged quarantine in China: a qualitative study

ObjectiveTo explore the psychological experiences of university students in prolonged quarantine during the COVID-19 pandemic.DesignA qualitative descriptive study based on semistructured interviews; data were analysed using a thematic topic analysis...

The influence of soil factors on protist community dynamics during plant succession in subalpine natural and planted forests

Protists, as the core component of the soil microbiome, may play an important role in forest succession by altering soil nutrient cycling and plant performance. However, knowledge of how protists change with plant succession is extremely limited. To illustrate protistan community dynamics following plant succession in subalpine natural and planted ecosystems, we used high-throughput sequencing to identify protists in rhizosphere and bulk soils at different successional stages, and the effects of soil abiotic and biotic factors on protists were analysed. Overall, the α-diversity and community composition of protists differed significantly between natural and planted ecosystems, but not between rhizosphere and bulk soils. Moving along the successional gradient, the richness and diversity of protists in rhizosphere and bulk soils of natural ecosystems, as well as the richness of functional taxa (i.e., consumers, parasites and phototrophs), gradually increased. In contrast, the richness of protists and functional taxa in the plantations was generally lowest in the old stands (75 years). The community composition of protists in rhizosphere and bulk soils of these two ecosystems varied significantly among successional stages, and their community composition variation was positively correlated with the time interval of successional stages, indicating that community dynamics exhibited directionality along successional gradients. Soil abiotic and biotic factors jointly regulate protistan α-diversity and community composition, and forest succession regulates functional taxa through multiple pathways. However, the key influencing factors and specific regulatory pathways are not consistent across different ecosystems, soil types and functional taxa. Therefore, our study has revealed that protistan community assembly was distinct along two separate successional gradients, indicating potential functional differences. These results provide a basis for the development of future forest management measures.

Measuring trust in one's physician: A scoping review.

Trust in one's physician drives positive health practices. However, the conceptualization and subsequent operationalization of trust have become clouded due to the multitude of approaches that have resulted in several different measures with varied dimensions and indicators. The objectives of this scoping review were: 1) to discover any new developments in the measurement of trust, 2) to identify those measures of trust, whether newly created or refined in the last ten years, that have known reliability and validity, and 3) to compare those instruments' conceptualizations, dimensions, and indicators. This researcher conducted an electronic search of three databases (PubMed, SOCAB, and PsycINFO). Two reviewers screened those selected studies and identified the following six key measurement tools, of which three had shorter, more abbreviated derivatives: the Trust in Physician Scale and its modification, the Wake Forest Physician Trust Scale and its short form, the Health Care Relationship Trust Scale and its refinement, the Trust in Oncologist Scale and its shortened form, the Trust in Health Care Providers Scale, and the Trust in My Doctor Scale. Of these six distinct tools, only the Trust in Oncologist Scale was developed and validated in non-US populations. Also identified were ten dimensions of trust: fidelity, technical competence, communicative competence, interpersonal competence (i.e., caring), honesty, confidentiality, global, behavioral, fairness, and system trust/accountability. Interpersonal competence and fairness emerged as newer dimensions that deserve further study. A comparative analysis of the indicators of these trust dimensions revealed some discrepancies that deserve theoretical and psychometric attention. In addition, incorporating item-response theory to assess measurement invariance has enhanced the assessment of external validity. This review provides a resource for researchers that will lead to a more uniform understanding of trust, thereby setting the basis for future theoretical integration and measurement development.

OLDER ADULT PERCEPTIONS OF HEALTHY AGING MEASURES

Abstract Little is known about how lay older adults view measures commonly employed to assess healthy aging. This study examined older adults’ perceptions of scales capturing psychological wellbeing, psychosocial factors, and physical health. Participants (n = 60 US adults; MAge = 65.49, 41.18% Female, 94.12% White) were asked to rate how easy each measure was to understand and interpret on a scale of 1 (Not easy at all) to 7 (Very easy). In addition, they were asked to identify any items with which they had difficulty responding. Finally, participants provided opinions of whether these scales fully addressed their perspective on healthy aging, or if additional components were needed. Results showed that, on average, participants rated the aging-related outcomes measures as easy to understand and interpret (M = 6.14). Older adults rated measures related to physical health and health behaviors as the easiest to use (the PROMIS Health Measure (M = 6.47) and the Good Health Practices Scale (M = 6.49)), while measures that capture future planning were the most difficult to comprehend and interpret (the Consideration of Future Consequences Scale (CFC; M = 5.19) and the Goals Related to Healthy Aging Scale (M = 5.73)). While participants generally reported satisfaction with the comprehensiveness of the measures, some (22%) felt that these measures did not fully capture the social aspects of aging. Future measurement development may benefit from older adults’ input to increase their utility and better capture the experiences of older adults.

Quantitative approaches to measuring structural cisgenderism

There is rapidly growing interest in understanding the impacts of structural cisgenderism on health and health inequities for transgender and nonbinary populations. This growing interest has led to an influx of novel measures of structural cisgenderism. In this commentary, we discuss and identify gaps in existing measures and offer considerations for the development of future measures. Developing and utilizing valid measures of structural cisgenderism is crucial to quantify its impacts on health and health inequities, and to inform public health interventions, laws, and policies to eliminate gender identity and modality-based health inequities.

Abstract 12510: Spatial and Temporal Effects on Human Health Following a Serious Natural Disaster

Introduction: The effects of disasters can be classified into direct effects and indirect effects. Although direct effects of disasters have been extensively reported, the reports on indirect effects are scarce. We analysed the long-term spatiotemporal effects of The Great East Japan Earthquake, which occurred on March 11, 2011, to elucidate its direct and indirect effects. Methods: The spatial analyses and the temporal analyses were performed using the data from Japanese Diagnosis Procedure Combination (DPC) database from August 01, 2010 to March 31, 2015. Results: The number of patients in DPC-participating hospitals showed apparent decrease with odds ratio of 0.46 (25th-75th percentile 0.10-0.80) immediately after the earthquake (Figure1), and the crude death ratio increased significantly with odds ratio of 1.78 (25th-75th percentile 1.13-2.26), lasting for 12 months (Figure2). This change was not only seen in the disaster area but in the broader area of Japan. The proportion of patients admitted to hospitals due to malignant disease largely decreased (53.8% before earthquake, 34.8% within 1 year after earthquake, odds ratio 0.65), and the proportion of patients admitted to hospitals due to cardiovascular disease largely increased (13.1% before earthquake, 28.5% after earthquake, odds ratio 2.17) within 1 year after the earthquake. Conclusions: A wide-scale natural disaster affects the number of patients and mortality prominently in the disaster area for at least 1 year, especially in patients with cardiovascular disease. The results of this study provide important information for development of future disaster control measures.

American Academy of Orthopaedic Surgeons Clinical Practice Guideline Summary of Surgical Management of Osteoarthritis of the Knee.

The Surgical Management of Osteoarthritis of the Knee Evidence-Based Clinical Practice Guideline is based on a systematic review of published studies for surgical management of osteoarthritis of the knee in skeletally mature patients. This guideline contains 16 recommendations and seven options to assist orthopaedic surgeons and all qualified physicians with the surgical management of patients with osteoarthritis of the knee based on the best current available evidence. It is also intended to serve as an information resource for professional healthcare practitioners and developers of practice guidelines and recommendations. In addition to providing pragmatic practice recommendations, this guideline also highlights gaps in the literature and informs areas for future research and quality measure development.

Analysis of the Effectiveness of Public Health Measures on COVID-19 Transmission.

In this study, we investigate the COVID-19 epidemics in Brazilian cities, using early-time approximations of the SIR model in networks and combining the VAR (vector autoregressive) model with machine learning techniques. Different from other works, the underlying network was constructed by inputting real-world data on local COVID-19 cases reported by Brazilian cities into a regularized VAR model. This model estimates directional COVID-19 transmission channels (connections or links between nodes) of each pair of cities (vertices or nodes) using spectral network analysis. Despite the simple epidemiological model, our predictions align well with the real COVID-19 dynamics across Brazilian municipalities, using data only up until May 2020. Given the rising number of infectious people in Brazil-a possible indicator of a second wave-these early-time approximations could be valuable in gauging the magnitude of the next contagion peak. We further examine the effect of public health policies, including social isolation and mask usage, by creating counterfactual scenarios to quantify the human impact of these public health measures in reducing peak COVID-19 cases. We discover that the effectiveness of social isolation and mask usage varies significantly across cities. We hope our study will support the development of future public health measures.

Patient-Reported Outcome Measures for Hearing Aid Benefit and Satisfaction: Content Validity and Readability.

Numerous patient-reported outcome measures (PROMs) are available to measure hearing aid benefit and satisfaction. It is unclear to what extent currently available PROMs on hearing aid outcomes, often developed decades ago, meet current guidelines for good content validity and readability. This study evaluated the content validity and readability of PROMs that focus on perceived hearing aid benefit and/or satisfaction. A literature review was conducted to identify eligible instruments. Content validity evaluation included mapping extracted questionnaire items to the World Health Organization's International Classification of Functioning, Disability and Health (ICF) framework. In addition, study design in content validity methodology was evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments study design checklist for PROM instruments. Readability was estimated using the Simple Measure of Gobbledygook measure. Thirteen questionnaires were identified and evaluated. Item content focused primarily on the components of environmental factors as well as activity limitations and participation restrictions with less emphasis on body functions and personal factors. The content validity methodology analysis revealed an underuse or lack of reporting of a qualitative methodology in assessing patient and professional perspectives. All the included questionnaires exceeded the recommended sixth-grade reading level. The categories covered by hearing aid PROMs vary considerably, with no single instrument comprehensively covering all the key ICF components. Future development of hearing aid outcome measures should consider a mixed methodology approach for improved content validity and ensure an appropriate reading level.

Persistent bullying and the influence of turning points: learnings from an instrumental case study

ABSTRACT Persistent bullying behavior is that which starts high and remains either moderately high or persistently high, seemingly in spite of intervention/prevention approaches employed: yet little is known about how/why persistent bullying emerges or is sustained. Those who do not respond to interventions and persist with their bullying behavior, require close consideration and more targeted, nuanced approaches. This instrumental case-study uniquely explores a self-identified, high-persistent bully’s explanations of how the bullying emerged, and what supported/sustained it to become a persistent behavior. A whole-of-life interview protocol facilitated a reflective exploration of the participant’s social and behavioral ‘turning points’: the influence of transitions and changes in one’s life: serving to initially steer him toward bullying others, and eventually sustaining his persistent bullying behavior over time. An interpretative phenomenological analysis (IPA) revealed three ‘turning points’ which seemingly met his primary personal and social goals/needs of belonging, social positioning and status. This paper adds to the literature by introducing the notion of ‘turning points’ as a possible mechanism that facilitates the emergence of, and sustains persistent negative/bullying behaviors. Understanding turning points and any chain reactions in the lives of those who engage in higher, persistent levels of bullying can inform the development of future measures, intervention approaches and provide insights into issues of care for individuals engaging in persistent bullying.

Telerehabilitation service impact on physical function and adherence compared to face-to-face rehabilitation in patients with stroke: A systematic review and meta-analysis.

The purposes of thissystematic review and meta-analysis were to (1) appraise the available evidence of telerehabilitation program effects on functional outcomes, adherence, and patient satisfaction compared to face-to-face programs after stroke; and (2) provide direction for future outcome measure selection and development for clinical research purposes. TYPE: Systematic review and meta analysis of randomized controlled trials. MEDLINE, CINAHL, Embase, Scopus, Proquest Theses and Dissertations, Physiotherapy Evidence Database (PEDro), and Clinicaltrials.gov were searched for studies published in English from 1964 to the end of April 2022. A total of 6450 studies were identified, 13 were included in the systematic review, and 10 with at least 3 reported similar outcomes were included the meta-analysis. Methodological quality of results was evaluated using the PEDro checklist. Telerehabilitation demonstrated equivalency in outcomes across several domains and was favored compared to conventional face to face alone or when paired with semisupervised physical therapy on Wolf Motor Function performance score (mean difference [MD] 1.69 points, 95% confidence interval [CI] 0.21-3.17) and time score (MD 2.07 seconds, 95% CI -4.04 to -0.10, Q test = 30.27, p < .001, I2 = 93%), and Functional Mobility Assessment in the upper extremities (MD 3.32 points, 95% CI 0.90-5.74, Q test = 5.60, p = .23, I2 = 29% alone or when paired with semisupervised physical therapy). The Barthel Index participation measures of function demonstrated improvement (MD 4.18 points, 95% CI, 1.79-6.57, Q test = 3.56, p = .31, I2 = 16%). Over half of summarized study ratings were determined to be of good to excellent quality (PEDro score 6.6 ± 2.3 points). Adherence varied in available studies from 75%-100%. Satisfaction levels of telerehabilitation were highly variable. Telerehabilitation can improve functional outcomes and promote therapy adherence after stroke. Therapy protocols and functional assessments need substantial refinement and standardization to improve interpretation and clinical outcomes.