Telerehabilitation for stroke patients: an overview of reviews

Abstract

Background: The increasing number of survivors following stroke events are enlightening new needs to guarantee appropriate care and quality of life support at home. A potential application of telemedicine is to provide home care and rehabilitation. Within the framework of an EU FP7 project called Integrated Home Care (IHC Grant Agreement no: 222954) we performed an overview of reviews on the telefacilities for the homecare in stroke patients.

Materials and methods: A broad literature research was conducted in PUBMED, Web of Science® and The Cochrane Library databases. We included and graded all the reviews according to the following criteria: published in English in peer-reviewed journals, targeting stroke as adult patients (age>18yr.) and considering a homecare setting in the intervention.

Results: 6 reviews were included (i.e. 1 systematic review with meta-analysis and 5 non-systematic reviews). No conclusions can be stated on the effectiveness of telerehabilitation compared to other home treatments, due to the insufficient data available, nevertheless strong indications emerged for the inclusion of “all cause mortality” and “hospital admission” as primary outcomes. Besides “QoL”, “cost”, “adherence” and “patient acceptability” should be included as secondary outcomes, for a complete evaluation of the tele-intervention. No adverse effects were reported in all the reviews, stating that tele-interventions appear to be safe as usual care at home.

Conclusion: Those indications should be considered as relevant in planning a telerehabilitation trial, in order to observe the expected effectiveness from a multidimensional point of view in the clinical, financial and social perspectives.