Telerehabilitation Initiated Early in Post-Stroke Recovery: A Feasibility Study.
Dylan Edwards, Sapna Kumar, Lorie Brinkman and 10 others
PMID 36876946WHAT IT FOUND
Early telerehabilitation added to usual post-stroke care was feasible: 16 patients completed the 6-week program, with 100% session compliance.
Arm scores improved, but no control group means natural recovery cannot be ruled out.
Key findings
01The primary feasibility outcome was met: 19 participants were allocated, 16 completed the intervention, retention was 84.2%, and compliance was 100%.
02Usual-care therapy during the interval was 33.9 ± 20.3 hours, and adding telerehabilitation more than doubled total therapy to 73.6 ± 21.8 hours.
03Arm motor scores improved after telerehabilitation, including an 18.1 ± 10.9 point gain on the Upper Extremity Fugl-Meyer, above the paper's 5.25-point minimum clinically important difference, but the study had no control group.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study had no control group, so arm score gains cannot be separated from usual care or natural early post-stroke recovery. It was a small pilot: 19 participants were allocated, 16 completed, and 15 had post-intervention outcome data. Usual-care therapy dose was available for only 11 participants, so the total dose comparison is incomplete. The primary outcomes were feasibility and safety, not efficacy. Participants were a convenience sample from two inpatient stroke rehabilitation sites, so generalizability is limited. Some adverse events were serious but unrelated to the study; they were general medical complications in early stroke recovery. The intervention included multiple components, including exercises, games, stroke education, and usual care, so the contribution of any single component cannot be isolated.
Declared interests
The authors received no financial support for the research, authorship, or publication. Dr. Cramer declared consulting relationships with multiple companies, including TRCare, which manufactured one of the telehealth systems used.
The easy way to misread this
Do not read the 18.1-point Fugl-Meyer gain as proof that telerehabilitation caused arm recovery. The primary outcome was feasibility, and the study had no control group, so natural early post-stroke recovery and usual therapy could explain the improvement.