Sarfo Fred S, Ulasavets Uladzislau, Opare-Sem Ohene K, Ovbiagele Bruce
Kwame Nkrumah University of Science & Technology, Kumasi, Ghana; Komfo Anokye Teaching Hospital, Kumasi, Ghana.
Jagiellonian University Medical College, Kraków, Poland.
J Stroke Cerebrovasc Dis. 2018 Sep;27(9):2306-2318. doi: 10.1016/j.jstrokecerebrovasdis.2018.05.013. Epub 2018 Jun 4.
Tele-rehabilitation for stroke survivors has emerged as a promising intervention for remotely supervised administration of physical, occupational, speech, and other forms of therapies aimed at improving motor, cognitive, and neuropsychiatric deficits from stroke.
We aimed to provide an updated systematic review on the efficacy of tele-rehabilitation interventions for recovery from motor, higher cortical dysfunction, and poststroke depression among stroke survivors.
We searched PubMed and Cochrane library from January 1, 1980 to July 15, 2017 using the following keywords: "Telerehabilitation stroke," "Mobile health rehabilitation," "Telemedicine stroke rehabilitation," and "Telerehabilitation." Our inclusion criteria were randomized controlled trials, pilot trials, or feasibility trials that included an intervention group that received any tele-rehabilitation therapy for stroke survivors compared with a control group on usual or standard of care.
This search yielded 49 abstracts. By consensus between 2 investigators, 22 publications met the criteria for inclusion and further review. Tele-rehabilitation interventions focused on motor recovery (n = 18), depression, or caregiver strain (n = 2) and higher cortical dysfunction (n = 2). Overall, tele-rehabilitation interventions were associated with significant improvements in recovery from motor deficits, higher cortical dysfunction, and depression in the intervention groups in all studies assessed, but significant differences between intervention versus control groups were reported in 8 of 22 studies in favor of tele-rehabilitation group while the remaining studies reported nonsignificant differences.
This updated systematic review provides evidence to suggest that tele-rehabilitation interventions have either better or equal salutary effects on motor, higher cortical, and mood disorders compared with conventional face-to-face therapy.
针对中风幸存者的远程康复已成为一种有前景的干预措施，用于远程监督实施物理、职业、言语及其他形式的治疗，旨在改善中风所致的运动、认知和神经精神功能障碍。
我们旨在对中风幸存者运动功能恢复、高级皮质功能障碍及中风后抑郁的远程康复干预效果进行最新的系统评价。
我们于1980年1月1日至2017年7月15日期间，使用以下关键词在PubMed和Cochrane图书馆进行检索：“远程康复中风”“移动健康康复”“远程医疗中风康复”及“远程康复”。我们的纳入标准为随机对照试验、试点试验或可行性试验，其中干预组接受针对中风幸存者的任何远程康复治疗，对照组接受常规或标准护理。
本次检索共获得49篇摘要。经两名研究者达成共识，22篇出版物符合纳入标准并进行进一步审查。远程康复干预主要集中在运动功能恢复（n = 18）、抑郁或照顾者负担（n = 2）以及高级皮质功能障碍（n = 2）。总体而言，在所有评估研究中，干预组的远程康复干预与运动功能障碍、高级皮质功能障碍及抑郁恢复的显著改善相关，但22项研究中有8项报告干预组与对照组之间存在显著差异，支持远程康复组，其余研究报告差异不显著。
本次更新的系统评价提供了证据，表明与传统面对面治疗相比，远程康复干预对运动、高级皮质和情绪障碍具有更好或同等的有益效果。
