The primary objective of this review was to synthesise and analyse the evidence regarding the impact of physiotherapy interventions delivered through TR on QoL in patients with stroke, PD, and MS. Secondary objectives included evaluating patient satisfaction and technology acceptance related to TR interventions, along with formulating specific research questions to guide the analysis
We included randomised controlled trials, controlled clinical trials, and quasi-randomised controlled trials. The risk of bias (ROB) was assessed using the Revised Cochrane Tool Risk of Bias 2 (RoB2) and the ROBINS-I tool. Quantitative analyses employed the standardised mean difference (SMD) for treatment effects, with a 95% confidence interval (CI) for continuous outcomes. Satisfaction and Technology acceptance were were qualitatively assessed and described. Meta-analyses were conducted using Review Manager 5.4, employing a random-effects model due to heterogeneity, with a 95% CI calculated accordingly.
From the initial 1,092 results, 28 studies were included in the qualitative analysis, and 16 in the quantitative analysis. TR was found to be safe, feasible, and comparable to in-person interventions. For stroke patients, TR significantly improved QoL [SMD (95% CI) = 0.41 (0.12, −0.70), I² = 68%]. However, the quality of evidence was moderate to high due to limitations in study design and reporting. Data on satisfaction and technology acceptance were limited. For PD and MS patients, TR demonstrated comparable efficacy to in-person treatments, and qualitative feedback suggested increased engagement and motivation.
TR holds significant potential to enhance QoL for individuals with neurological conditions, particularly stroke. However, the quality of evidence varies, and further research is needed to address limitations in study design and reporting, as well as to explore patient satisfaction and technology acceptance in more detail.
Integrating TR into physiotherapy practice could enhance access to care and improve QoL for patients with neurological conditions. While the findings of this review indicate promise, it is essential for physiotherapists to receive appropriate training in TR technologies to implement these interventions effectively. From a policy perspective, the evidence could support discussions around the allocation of resources for developing and implementing TR programs, although further research is needed to substantiate these claims. This includes exploring funding opportunities and ensuring equitable access for patients, especially in underserved regions. Overall, these findings highlight the need for ongoing investigation into TR as a viable rehabilitation strategy, as well as the potential benefits for patient outcomes.
QoL
neurological disease*
