Efficiency of telerehabilitation on subacute stroke ambulation: a matched case-control study.

Abstract

Background Stroke now represents the condition with the highest need for physical rehabilitation worldwide, with only low or moderate-level evidence testing telerehabilitation compared to in-person care. We compared functional ambulation in subacute patients with stroke following telerehabilitation and matched in-person controls with no biopsychosocial differences at baseline. Methods We conducted a matched case-control study to compare functional ambulation between individuals with stroke following telerehabilitation and in-person rehabilitation, assessed using the Functional Ambulation Categories (FAC) and the Functional Independence Measure™ (FIM). Results The telerehabilitation group (n =38) achieved significantly higher FAC gains (1.5 (1.3) vs 1.0 (1.0)) than the in-person rehabilitation group, with no differences in ambulation efficiency, in individuals: admitted to rehabilitation within 60days after stroke onset; aged 49.8 (±11.4) years at admission; 55.3% female sex; moderate stroke severity; 42.1% with 'good' motor FIM at baseline; mostly living with sentimental partner (73.7%); with 21.1% holding an university education degree. Conclusions The groups showed no significant differences in ambulation efficiency, though the telerehabilitation group achieved higher FAC gains. Our results suggest that home telerehabilitation can be considered a good alternative to in-person rehabilitation when addressing ambulation in patients with moderate stroke severity and whose home situation mostly includes a cohabiting partner.