Factors influencing the delivery of telerehabilitation for stroke: a systematic review

Aoife Stephenson, Sarah Howes, Paul Murphy, Judith Deutsch, Maria Stokes, Katy Pedlow, S McDonough

Research output: Contribution to journalReview articlepeer-review

Abstract

Objective: Despite the available evidence regarding effectiveness of stroke telerehabilitation, there has been little focus on factors influencing its delivery or translation from the research setting into practice. There are complex challenges to embedding telerehabilitation into stroke services and generating transferable knowledge about scaling up and routinising this service model. This review aimed to explore factors influencing the delivery of stroke telerehabilitation interventions, including platforms, technical requirements, training, support, access, cost, usability and acceptability.

Methods: MEDLINE, EMBASE, CINAHL, Web of Science and Cochrane Library and Central Registry of Clinical Trials were searched to identify full-text articles of randomised controlled trials (RCTs) and protocols for RCTs published since a Cochrane review on stroke telerehabilitation services. A narrative synthesis was conducted, providing a comprehensive description of the factors influencing stroke telerehabilitation intervention delivery.

Results: Thirty-one studies and ten protocols of ongoing studies were included. Interventions were categorised as synchronous telerehabilitation (n = 9), asynchronous telerehabilitation (n = 11) and tele-support (n = 11). Telephone and videoconference were the most frequently used modes of delivery. Usability and acceptability with telerehabilitation were high across all platforms, although access issues and technical challenges may be potential barriers to the use of telerehabilitation in service delivery. Costs of intervention delivery and training requirements were poorly reported.

Conclusions: This review synthesises the evidence relating to factors that may influence stroke telerehabilitation intervention delivery at a crucial timepoint given the rapid deployment of telerehabilitation in response to the COVID-19 pandemic. It recommends strategies, such as ensuring adequate training and technical infrastructure, shared learning and consistent reporting of cost and usability and acceptability outcomes, to overcome challenges in embedding and routinising this service model and priorities for research in this area.
Original languageEnglish
Article numbere0265828
Pages (from-to)1-30
Number of pages30
JournalPLoS ONE
Volume17
Issue number5
DOIs
Publication statusPublished - 11 May 2022

Bibliographical note

AS’s time was co-funded by Royal College of Surgeons in Ireland (School of Physiotherapy) and the European Union’s Horizon 2020 Research and Innovation Programme under grant agreement no. 687228, MAGIC PCP. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Keywords

  • Stroke
  • Telerehabilitation
  • Covid-19
  • Technical Requirements
  • Usability and Acceptability

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