Stroke is a major public health concern. Recovery after stroke often involves travelling to rehabilitation centers, facing long waiting times, and struggling to continue therapy regularly after returning home. A systematic review published in Healthcare, which analyzed more than 1000 participants across 21 international studies, showed a shift in practice. Exercise-based telerehabilitation is possible and produces clinical outcomes comparable with conventional physiotherapy.

Speaking with Univadis Spain, part of the Medscape Professional Network, Virgilio Fuentes, MD, head of the Rehabilitation Department at Ibermutuamur in Murcia, Spain, noted that stroke affects 1 in 4 individuals in Spain during their lifetime and occurs in approximately 120,000 individuals each year. Stroke is the leading cause of acquired disability in adults and compromises independence and quality of life. After hospital discharge, recovery extends over months, with persistent impairments in mobility, reduced functional capacity, and difficulty in performing activities of daily living.

Technology has narrowed this gap between patients and clinicians. In a study led by Yaiza Casas Rodríguez, physiotherapist from the Primary Health Care, Institut Català de la Salut in Barcelona, Spain, and multidisciplinary Spanish researchers, 1067 participants received structured rehabilitation interventions delivered through video calls, mobile applications, and wearable devices. The participants showed significant improvements in functional capacity, mobility, and balance. Telerehabilitation enabled delivery of therapy in the home setting, removing geographic barriers and transportation costs. The possibility of continuing recovery from home not only improved their functionality but also their autonomy and quality of life. Participants also showed improved adherence to prescribed exercise programs, increased confidence in recovery, and higher satisfaction among both individuals and caregivers.

Researchers have reported that clinical outcomes depend primarily on program design rather than the specific technology used. Structured, progressive, and supervised exercise protocols produced the most consistent improvements. Programs that incorporated repetitive practice and tasks aligned with activities of daily living, including walking, dressing, and strengthening of the upper limbs, achieved the strongest functional outcomes. 

Fuentes explained that “this approach is especially important during the so-called sensitive time window, which includes the first 3-6 months after stroke, a period of greater neuronal plasticity and improved response to intensive training.” Improvements in gait, balance, and performance of daily activities were observed during this period.

Family involvement emerged as a key determinant of program effectiveness. Caregiver participation increased exercise frequency, improved participant satisfaction, and reduced caregiver burden. This finding supports the integration of structured social support into rehabilitation models.

Beyond physical recovery, telerehabilitation also shows important psychological benefits:

• Self-efficacy: Patients reported greater confidence in managing their recovery and engaging in rehabilitation tasks independently.
• Adherence: Remote delivery supports sustained participation, making it easier for patients to continue prescribed exercises over time.
• Emotional well-being: Improvements in mood and reductions in anxiety were observed along with physical recovery.

However, researchers recommend caution in interpreting these findings. The evidence base includes relatively small sample sizes, heterogeneous study designs, and methodologic limitations, including the inability to blind participants. These factors reduce confidence in the strength of the conclusions. Larger, standardized clinical trials are needed to establish long-term effectiveness.

Exercise-based motor telerehabilitation should not be viewed as a secondary option. Evidence shows that it functions both as a therapeutic complement and as a viable alternative to conventional physiotherapy after stroke, with comparable improvements in mobility, motor function, and quality of life. Its effectiveness depends on well-designed and clinician-supervised exercise programs, supporting continuity of treatment, and sustained patient engagement, rather than on the complexity of the technology used.

After a stroke, each step in the recovery process is important. In an increasingly connected world, this approach shows that the most effective setting to restore function and independence is often the patient’s home.

The authors and Fuentes reported having no relevant conflicts of interest. 

This story was translated from Univadis Spain.