Effects of Exercise-Based Telerehabilitation Programs on Functional Recovery and Related Outcomes After Stroke: A Systematic Review

Abstract

Background/Objectives: Stroke is a leading cause of long-term disability, resulting in motor and functional impairments that compromise independence and quality of life. Telerehabilitation offers a promising solution by providing remote, continuous, and accessible post-stroke therapy. This systematic review examined the effects of telerehabilitation on functional capacity, mobility, balance, and quality of life in stroke survivors. Methods: A systematic search was conducted following PRISMA guidelines and registered in PROSPERO (CRD420251169784). Searches in PubMed, Cochrane Library, PEDro, Web of Science, Scopus and CINAHL ultimately identified randomized controlled and quasi-experimental trials from the last decade involving adult stroke patients receiving exercise-based telerehabilitation. Methodological quality was assessed using Joanna Briggs Institute tools and Cochrane risk of bias evaluation. Twenty-one studies with a total of 1067 participants were included, featuring supervised tele-sessions, autonomous exercises, caregiver-assisted training, and hybrid approaches. Results: Results demonstrated significant improvements in functional capacity, motor performance, balance, and quality of life, comparable to conventional rehabilitation. Additional benefits included enhanced self-efficacy, treatment adherence, and caregiver satisfaction. Overall risk of bias was low, though participant blinding was unfeasible. Conclusions: Telerehabilitation may represent a strategy for post-stroke recovery, with studies suggesting outcomes comparable to conventional face-to-face rehabilitation while enhancing accessibility and psychosocial well-being. However, further well-designed, standardized trials with longer follow-up periods are required to confirm its clinical effectiveness.