Allied rehabilitation using caregiver-mediated exercises combined with telerehabilitation for stroke (ARMed4Stroke): A randomised controlled trial.

The trial was underpowered: 41 dyads were recruited against a target of 72, partly because of the pandemic, and a futility analysis stopped recruitment early. The primary outcome (Stroke Impact Scale mobility, 0 to 100) may have a ceiling effect in relatively mild stroke patients, making it hard to detect a real difference. A significantly higher proportion of lacunar strokes was in the intervention group, which may have affected the ceiling effect or prognosis. Total exercise time did not differ significantly between groups (p = 0.221), so the intervention may not have delivered a meaningfully higher dose of training. Patients were relatively young (mean 62 years) and mostly recruited from inpatient rehabilitation, limiting generalisability to older or community-based populations. Exercise minutes were self-reported rather than objectively measured.

Funded by the Royal Dutch Society for Physiotherapy Scientific College (KNGF-WCF) and the Netherlands Organisation for Health Research and Development (ZonMw). The authors declared no conflicts of interest. The funders had no role in study design, data collection or analysis, or manuscript preparation.

Do not read the caregiver wellbeing gains or the 6-month leisure ADL improvement as evidence the programme improves patient mobility. The primary outcome was null (p = 0.826), the trial was underpowered (41 of 72 dyads recruited), and total exercise time did not differ significantly between groups (p = 0.221).