Telerehabilitation After Stroke Using Readily Available Technology: A Randomized Controlled Trial.

Only 95 participants were randomized, although the planned total was 96, and 6-month physical function data were available for 39 in the ACTIV group and 44 in the control group. Of 4126 admitted patients, 655 declined, 428 could not be contacted, and 659 did not meet physical or cognitive criteria, so the results may not apply to all stroke survivors. The trial included only first-ever hemispheric strokes and excluded brainstem or cerebellar strokes. Participants needed basic-level English, and multilingual text messages were not funded. Additional usual care was not measured, so other services could have affected outcomes. The per-protocol analysis excluded 4 participants, 3 of whom had no 6-month outcome data. All participants had already completed usual rehabilitation, so the trial tested a small addition of input. ACTIV combined face-to-face visits, phone calls, and text messages, so the contribution of any single component cannot be separated. Only one-way text messages were used, which may have reduced engagement.

The authors declared no potential conflicts of interest. The Health Research Council of New Zealand funded the study.

Do not conclude that phone calls or text messages alone caused the per-protocol physical function gain. The program included face-to-face visits, phone calls, and text messages, and the contribution of any single component cannot be separated. The main randomized comparison was not significant, and the 12-month follow-up showed no retained physical function gain.