Task-oriented telerehabilitation for upper limb functional recovery after stroke: a retrospective cohort study

BackgroundsIn clinical practice, many patients cannot undergo inpatient rehabilitation in hospitals for extended periods due to personal financial constraints, as well as China’s health insurance policy. They are often forced to terminate their rehabilitation training during the prime recovery phase...

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Main Authors: Xiaojuan Hong, Huanghong Cha, Xiao Bao, Jinning Luo, Xiuling Li, Jinling Cheng, Zicai Liu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Neurology
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Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2025.1611565/full
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author Xiaojuan Hong
Huanghong Cha
Xiao Bao
Jinning Luo
Xiuling Li
Jinling Cheng
Zicai Liu
author_facet Xiaojuan Hong
Huanghong Cha
Xiao Bao
Jinning Luo
Xiuling Li
Jinling Cheng
Zicai Liu
author_sort Xiaojuan Hong
collection DOAJ
description BackgroundsIn clinical practice, many patients cannot undergo inpatient rehabilitation in hospitals for extended periods due to personal financial constraints, as well as China’s health insurance policy. They are often forced to terminate their rehabilitation training during the prime recovery phase. This makes tele-rehabilitation-based, home-based rehabilitation particularly important.PurposeThis retrospective cohort study aimed to compare the efficacy of tele-rehabilitation-based task-oriented training (TOT) versus face-to-face task-oriented training and conventional tele-neurofacilitation techniques.MethodsPatients who met the criteria were assigned to either the telerehabilitation group, the FTF group, or the Tele-Control group while receiving standardized rehabilitation treatment and education. Moreover, the Tele-Rehab group underwent tele-rehabilitation-based task-oriented training, the FTF group underwent face-to-face task-oriented training, and the Tele-Control Group underwent tele-rehabilitation-based conventional neurofacilitation techniques. The main evaluation indices were the Fugl-Meyer Assessment Upper Extremity Scale (FMA-UE), Wolf Motor Function Test (WMFT), and Action Research Arm Test (ARAT). Secondary outcome indicators were Instrumental Activities of Daily Living (IADL). All patients underwent 3 weeks of treatment.ResultsIn total, 79 participants completed the trial: Tele-rehab group (n = 23), FTF group (n = 28), and Tele-Control group (n = 28). Improvements in FMA-UE, WMFT, ARAT, and IADL were found in all three groups (p<0.05). The mean change in FMA-UE was 9.4 in the Tele-rehab group, 6.4 in the FTF group, and 6.7 in the Tele-control group. The mean difference between the Tele-Rehab and FTF groups was 3.0, and the mean difference between the Tele-Rehab and Tele-Control groups was 2.7, with the upper limit of the 95% confidence interval not exceeding the margin of non-inferiority. Non-inferiority was demonstrated, as the 95% CI did not cross the margin in FMA-UE difference scores before and after the intervention in the Tele-rehab group compared with the FTF group (p > 0.05), nor in the FTF group compared with the Tele-Control group before and after the intervention (p > 0.05). The 95% CI for FMA-UE improvement between Tele-rehab TOT and face-to-face TOT was [−0.81, 7.39], not exceeding the non-inferiority margin of 12.4.ConclusionTask-oriented training and remote traditional neurofacilitation techniques for tele-rehabilitation of stroke patients can enhance upper limb motor function and improve quality of daily life with comparable efficacy to face-to-face task-oriented training. Therefore, telerehabilitation is a method that is not inferior to conventional rehabilitation and deserves to be used and promoted in homebound patients.
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spelling doaj-art-fa1a828e3ba14f0db1f85fbf57c1092e2025-08-21T04:10:40ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-08-011610.3389/fneur.2025.16115651611565Task-oriented telerehabilitation for upper limb functional recovery after stroke: a retrospective cohort studyXiaojuan Hong0Huanghong Cha1Xiao Bao2Jinning Luo3Xiuling Li4Jinling Cheng5Zicai Liu6Department of Rehabilitation Medicine, Yuebei People's Hospital, Shaoguan, ChinaDepartment of Rehabilitation Medicine, Yuebei People's Hospital, Shaoguan, ChinaDepartment of Rehabilitation Medicine, Yuebei People's Hospital, Shaoguan, ChinaDepartment of Rehabilitation Medicine, Yuebei People's Hospital, Shaoguan, ChinaDepartment of Rehabilitation Medicine, Yuebei People's Hospital, Shaoguan, ChinaDepartment of Rehabilitation Medicine, Shaoguan First People's Hospital, Shaoguan, ChinaDepartment of Rehabilitation Medicine, Shaoguan First People's Hospital, Shaoguan, ChinaBackgroundsIn clinical practice, many patients cannot undergo inpatient rehabilitation in hospitals for extended periods due to personal financial constraints, as well as China’s health insurance policy. They are often forced to terminate their rehabilitation training during the prime recovery phase. This makes tele-rehabilitation-based, home-based rehabilitation particularly important.PurposeThis retrospective cohort study aimed to compare the efficacy of tele-rehabilitation-based task-oriented training (TOT) versus face-to-face task-oriented training and conventional tele-neurofacilitation techniques.MethodsPatients who met the criteria were assigned to either the telerehabilitation group, the FTF group, or the Tele-Control group while receiving standardized rehabilitation treatment and education. Moreover, the Tele-Rehab group underwent tele-rehabilitation-based task-oriented training, the FTF group underwent face-to-face task-oriented training, and the Tele-Control Group underwent tele-rehabilitation-based conventional neurofacilitation techniques. The main evaluation indices were the Fugl-Meyer Assessment Upper Extremity Scale (FMA-UE), Wolf Motor Function Test (WMFT), and Action Research Arm Test (ARAT). Secondary outcome indicators were Instrumental Activities of Daily Living (IADL). All patients underwent 3 weeks of treatment.ResultsIn total, 79 participants completed the trial: Tele-rehab group (n = 23), FTF group (n = 28), and Tele-Control group (n = 28). Improvements in FMA-UE, WMFT, ARAT, and IADL were found in all three groups (p<0.05). The mean change in FMA-UE was 9.4 in the Tele-rehab group, 6.4 in the FTF group, and 6.7 in the Tele-control group. The mean difference between the Tele-Rehab and FTF groups was 3.0, and the mean difference between the Tele-Rehab and Tele-Control groups was 2.7, with the upper limit of the 95% confidence interval not exceeding the margin of non-inferiority. Non-inferiority was demonstrated, as the 95% CI did not cross the margin in FMA-UE difference scores before and after the intervention in the Tele-rehab group compared with the FTF group (p > 0.05), nor in the FTF group compared with the Tele-Control group before and after the intervention (p > 0.05). The 95% CI for FMA-UE improvement between Tele-rehab TOT and face-to-face TOT was [−0.81, 7.39], not exceeding the non-inferiority margin of 12.4.ConclusionTask-oriented training and remote traditional neurofacilitation techniques for tele-rehabilitation of stroke patients can enhance upper limb motor function and improve quality of daily life with comparable efficacy to face-to-face task-oriented training. Therefore, telerehabilitation is a method that is not inferior to conventional rehabilitation and deserves to be used and promoted in homebound patients.https://www.frontiersin.org/articles/10.3389/fneur.2025.1611565/fullstroketelerehabilitationtask-oriented trainingclinical trialsupper limb dysfunction
spellingShingle Xiaojuan Hong
Huanghong Cha
Xiao Bao
Jinning Luo
Xiuling Li
Jinling Cheng
Zicai Liu
Task-oriented telerehabilitation for upper limb functional recovery after stroke: a retrospective cohort study
Frontiers in Neurology
stroke
telerehabilitation
task-oriented training
clinical trials
upper limb dysfunction
title Task-oriented telerehabilitation for upper limb functional recovery after stroke: a retrospective cohort study
title_full Task-oriented telerehabilitation for upper limb functional recovery after stroke: a retrospective cohort study
title_fullStr Task-oriented telerehabilitation for upper limb functional recovery after stroke: a retrospective cohort study
title_full_unstemmed Task-oriented telerehabilitation for upper limb functional recovery after stroke: a retrospective cohort study
title_short Task-oriented telerehabilitation for upper limb functional recovery after stroke: a retrospective cohort study
title_sort task oriented telerehabilitation for upper limb functional recovery after stroke a retrospective cohort study
topic stroke
telerehabilitation
task-oriented training
clinical trials
upper limb dysfunction
url https://www.frontiersin.org/articles/10.3389/fneur.2025.1611565/full
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