Telerehabilitation Approaches for Stroke Patients: Systematic Review and Meta-analysis of Randomized Controlled Trials.
BACKGROUND
Stroke remains one of the most common causes of adult disability in the world. In recent years, diverse telerehabilitation programs have been conceived and studied to improve the abilities of the activities of daily living and increased independence of stroke patients living at home. The systematic review was conducted to determine whether telerehabilitation leads to an improvement in abilities of activities of daily living for stroke patients.


METHODS
Randomized controlled trials (RCTs) evaluating the effects of telerehabilitation in stroke survivors living at home were identified by searching 7 electronic databases from inception to March 2015, and by hand searching for conference literatures between 2000 and 2015. Assessments of risk bias and data extraction were conducted independently by 2 reviews.


RESULTS
The search strategy identified 2587 records, of which 11 studies were thought to be eligible. Pooled results from 7 studies showed no significant differences in abilities of activities of daily living (Barthel Index scale: standardized mean difference [SMD] -.05, 95% confidence interval [CI] -.24 to .13; Berg Balance Scale: SMD -.05, 95% CI -.7 to .37) and motor function (Fugl-Meyer Extremity: SMD .05, 95% CI -.09 to 1.09) between groups.


CONCLUSIONS
This review provides limited, moderate evidence that telerehabilitation of all approaches has equal effects with conventional rehabilitation in improving abilities of activities of daily living and motor function for stroke survivors. Further research of RCTs in this area (rehabilitation field of telemedicine) is ungently required to extend the evidence base.
Department of Neurology, The Fifth People's Hospital of Shanghai, Fudan University, 801 Heqing Road, Minhang District, Shanghai 200240, China.
Jing
J
Chen
Department of Neurology, The Fifth People's Hospital of Shanghai, Fudan University, 801 Heqing Road, Minhang District, Shanghai 200240, China.
Wei
W
Jin
Department of Neurology, The Fifth People's Hospital of Shanghai, Fudan University, 801 Heqing Road, Minhang District, Shanghai 200240, China.
Xiao-Xiao
XX
Zhang
Department of Neurology, The Fifth People's Hospital of Shanghai, Fudan University, 801 Heqing Road, Minhang District, Shanghai 200240, China.
Wei
W
Xu
Department of Neurology, The Fifth People's Hospital of Shanghai, Fudan University, 801 Heqing Road, Minhang District, Shanghai 200240, China.
Xiao-Nan
XN
Liu
Department of Neurology, The Fifth People's Hospital of Shanghai, Fudan University, 801 Heqing Road, Minhang District, Shanghai 200240, China. Electronic address: rccfsn17@sina.com.
Chuan-Cheng
CC
Ren
D000203:Activities of Daily Living; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D020127:Recovery of Function; D000071939:Stroke Rehabilitation; D000069350:Telerehabilitation
Rehabilitation; meta-analysis; stroke; systematic review; telemedicine