The primary objective of this systematized review was to assess the effectiveness of telehealth interventions in promoting physical activity in community-dwelling stroke survivors. Specifically, the review aimed to assess these intervention’s impact on physical activity levels and sedentary behavior and analyze the strengths and limitations of existing studies.
We conducted a comprehensive search of four electronic databases (CINAHL, Scopus, MEDLINE, and PubMed) using appropriate keywords and synonyms to identify eligible studies published between 2010 and June 2024. Studies were eligible if they were randomized control trials (RCTs) included community-dwelling stroke survivors and tested a telehealth intervention aimed at improving physical activity or reducing sedentary behavior after stroke. Telehealth intervention can be delivered by telephone call, or mobile application. We appraised the quality of the RCT using the PEDro scale and the revised Cochrane risk-of-bias tool, and extracted data on study characteristics. Results were descriptively integrated due to data heterogeneity, and thus, no meta-analysis was conducted. A narrative synthesis was employed to provide a comprehensive overview of the impact of telehealth on physical activity levels from the evidence collected.
Six RCTs involving 654 participants were included in the review. Of the six RCTs, delivery of the telehealth intervention was done via telephone calls (four RCTs), and mobile applications (two RCTs). Physical activity (PA) was measured via activity trackers (three RCTs) and self-reported measures (three RCTs). Significant improvements were found in the reduction of sedentary behavior (three of five RCTs) and increase in moderate to vigorous intensity PA (three of four RCTs). The effectiveness of these interventions varied depending on factors such as the duration of the intervention and the type of technology used. Some studies had high risk of bias. Methodological limitations such as lack of blinding and small sample sizes were noted in some studies.
Telehealth intervention may improve physical activity and reduce sedentary behavior. However, results need to be interpreted with caution due to high risk-of-bias of some studies. The flexibility and accessibility of telehealth may help overcome barriers associated with traditional rehabilitation programs. More rigorous research is needed to establish standardized intervention protocols. Future research should focus on larger sample sizes, long-term follow-up, and the use of objective measurement tools to assess the effectiveness and sustainability of telehealth interventions.
Telehealth intervention may be an effective method to increase physical activity and reduce sedentary behavior in community-dwelling stroke survivors. This study can contribute to the development of methods to promote physical activity in community-dwelling stroke survivors.
stroke
telehealth
