title: Effects of telerehabilitation on physical function and disability for stroke patients: a randomized, controlled trial.
abstract: OBJECTIVE
  To determine the effect of a multifaceted stroke telerehabilitation (STeleR) intervention on physical function, and secondarily on disability, in veterans poststroke.
  
  
  METHODS
  We conducted a prospective, randomized, multisite, single-blinded trial in 52 veterans with stroke from 3 Veterans Affairs medical centers. Veterans with a stroke in the preceding 24 months were randomized to the STeleR intervention or usual care. The STeleR intervention consisted of 3 home visits, 5 telephone calls, and an in-home messaging device provided over 3 months to instruct patients in functionally based exercises and adaptive strategies. Usual care participants received routine rehabilitation care as prescribed by their physicians. The primary outcome measures were improvement in function at 6 months, measured by both the motor subscale of the Telephone Version of Functional Independence Measure and by the function scales of the Late-Life Function and Disability Instrument.
  
  
  RESULTS
  The 2 complementary primary outcomes (Late-Life Function and Disability Instrument Function and Telephone Version of Functional Independence Measure) improved at 6 months for the STeleR group and declined for the usual care group, but the differences were not statistically significant (P=0.25, Late-Life Function and Disability Instrument; P=0.316). Several of secondary outcomes were statistically significant. At 6 months, compared with the usual care group, the STeleR group showed statistically significant improvements in 4 of the 5 Late-Life Function and Disability Instrument disability component subscales (P<0.05), and approached significance in 1 of the 3 Function component subscales (P=0.06).
  
  
  CONCLUSIONS
  The STeleR intervention significantly improved physical function, with improvements persisting up to 3 months after completing the intervention. STeleR could be a useful supplement to traditional poststroke rehabilitation given the limited resources available for in-home rehabilitation for stroke survivors.
  
  
  BACKGROUND
  URL: http://www.clinicaltrials.gov. Unique identifier: NCT00384748.
authors.affiliation: VA HSR&D Center of Excellence on Implementing Evidence-Based Practice, Richard L. Roudebush VAMC, Indianapolis, IN 46202-2884, USA. nchumble@iupui.edu
authors.forename: Neale R
authors.initials: NR
authors.lastname: Chumbler
authors.forename: Patricia
authors.initials: P
authors.lastname: Quigley
authors.forename: Xinli
authors.initials: X
authors.lastname: Li
authors.forename: Miriam
authors.initials: M
authors.lastname: Morey
authors.forename: Dorian
authors.initials: D
authors.lastname: Rose
authors.forename: Jon
authors.initials: J
authors.lastname: Sanford
authors.forename: Patricia
authors.initials: P
authors.lastname: Griffiths
authors.forename: Helen
authors.initials: H
authors.lastname: Hoenig
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000534:rehabilitation*; D005260:Female; D006699:Home Care Services; D006801:Humans; D035002:Lower Extremity; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018401:Sample Size; D016037:Single-Blind Method; D000071939:Stroke Rehabilitation; D017216:Telemedicine / Q000379:methods*; D013689:Telephone; D016896:Treatment Outcome; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans