The primary aim of this study was to evaluate the effectiveness of a multi-domain TR programme, incorporating physiotherapy, speech therapy, and neuropsychological treatments tailored to the individual needs of stroke survivors. A secondary objective was to identify key factors influencing recovery and assess how these factors impact the outcomes of the TR programme. Additionally, the relationship between health-related quality of life (HRQoL) and rehabilitation progress was examined.
This multi-centre, longitudinal pilot study involved 84 stroke survivors (data from 74 analysed) who completed 20 tailored TR sessions per domain (physiotherapy, speech therapy, neuropsychological treatments). Assessments were conducted pre- and post-treatment using the Fugl-Meyer Assessment (FMA-UE) for motor function, Nine-Hole Peg Test (NHPT) for dexterity, Aachener Aphasia Test (AAT) for linguistic function, Montreal Cognitive Assessment (MoCA) for cognitive function, Barthel Index (BI) for activities of daily living (ADL) independence, Short Form 36 (SF-36) for HRQoL, and Beck Depression Inventory (BDI) for depressive symptoms. Statistical analyses included paired t-tests or Wilcoxon tests, ANOVA/Kruskal–Wallis tests with Holm's correction for post hoc comparisons and generalized linear regression models (GLRMs) to explore causal relationships between treatment outcomes and baseline characteristics. A significance level of p 0.05 was established for all tests.
Positive correlations were found between initial motor function, cognitive status, and ADL independence with motor function improvements post-TR (pseudo-R² = 0.90). The overall sample demonstrated significant improvements across several key areas: fine motor skills (NHPT: p 0.001), upper-limb functionality (FMA-UE-Motor: p 0.001; FMA-UE-Pain-ROM: p 0.001), and balance (FMA-Balance: p = 0.002). Additionally, participants showed enhanced independence (BI: p 0.001) and improved HRQoL, particularly in physical functioning (SF-36-PF: p = 0.029). Cognitive function also improved (MoCA: p 0.001).
This study supports the efficacy of a tailored, interdisciplinary TR programme in enhancing recovery for stroke survivors, particularly in motor and cognitive domains. Customised treatments, based on individual needs and interdisciplinary collaboration, played a key role in the programme’s success.
The findings underscore the potential of TR as a viable alternative to traditional rehabilitation methods, especially for individuals in remote areas. Implementing integrated TR programmes may enhance access to essential therapies, improve patient outcomes, and ultimately contribute to the reduction of long-term disability caused by stroke. Further research is recommended to explore the long-term impacts and cost-effectiveness of TR, particularly for individuals with lower baseline HRQoL.
telerehabilitation
personalized medicine
