Telerehabilitation matches in-person stroke therapy for arm recovery only when dose is matched, systematic review finds

A systematic review identified four randomised controlled trials, totalling 226 participants, comparing telerehabilitation with conventional in-person rehabilitation for motor function and activities of daily living after stroke Synthesis. The one adequately powered, dose-matched trial found telerehabilitation noninferior to in-person care for arm motor recovery. The three smaller trials, which did not match therapy dose or content between the telerehabilitation and in-person arms, showed mixed or null results. Certainty of evidence was rated very low throughout.

The review’s authors are explicit that telerehabilitation is evidenced as non-inferior only when dose and content are matched to standard in-person care — not shown to be superior, and not shown to work simply by virtue of being delivered remotely.

For services considering telerehabilitation to address geographic access barriers to in-person stroke therapy, the implication is specific: expansion should be designed to match therapy dose and content to standard care, rather than assuming that remote delivery alone reproduces the outcomes of in-person rehabilitation.