Deshmukh Shravni, Madhavan Sangeetha
Department of Physical Therapy, Brain Plasticity Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States.
Graduate Program in Rehabilitation Science, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States.
Front Rehabil Sci. 2023 May 17;4:1154686. doi: 10.3389/fresc.2023.1154686. eCollection 2023.
OBJECTIVES: The purpose of this systematic review is to analyze primary studies investigating the effects of telerehabilitation on walking outcomes for the treatment of adult stroke survivors. METHODS: Data sources included PubMed, Embase and CINAHL searched until August 2022, using combinations of several keywords such as "telerehabilitation", "stroke", and "gait". Studies were required to have bidirectional form of videoconferencing with assessor presence, and include assessment of walking function (speed, endurance and/or balance). Data extraction was performed from each full text by one author, and quality and bias were assessed using the Physiotherapy Evidence Database (PEDro). RESULTS: Eight studies involving 248 participants met the inclusion criteria. Seven reported significant improvements in outcomes of balance and two showed improvements in endurance after telerehabilitation. Two studies observed greater balance improvements in the telerehabilitation group compared to control and/or in-person therapy. Differences in frequency, training duration, intervention type, and absence of an in-person therapy control group were identified as causes of variation between studies. CONCLUSIONS: The effectiveness of telerehabilitation as a mode of therapy for walking could not be definitively determined due to the limited number of studies that directly measured walking speed or endurance. However, strong evidence was found for the use of telerehabilitation for balance improvements, which has implications for walking recovery. IMPACT STATEMENT: Telerehabilitation appears to be safe, feasible and demonstrated high adherence. Our results highlighted limited studies using real-time supervision to administer telerehabilitation and lack of studies focusing on outcomes of walking speed and endurance, needed to fully determine the role of telerehabilitation for gait recovery. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO number CRD42021238197.
目的:本系统评价旨在分析关于远程康复对成年中风幸存者步行功能影响的初步研究。 方法:数据来源包括截至2022年8月检索的PubMed、Embase和CINAHL,使用了“远程康复”“中风”和“步态”等多个关键词组合。研究需具备评估者在场的双向视频会议形式,并包括对步行功能(速度、耐力和/或平衡)的评估。由一位作者从每篇全文中进行数据提取,并使用物理治疗证据数据库(PEDro)评估质量和偏倚。 结果:八项涉及248名参与者的研究符合纳入标准。七项研究报告称远程康复后平衡结果有显著改善,两项研究显示耐力有所改善。两项研究观察到与对照组和/或面对面治疗相比,远程康复组的平衡改善更大。研究之间的差异被确定为频率、训练持续时间、干预类型以及缺乏面对面治疗对照组等因素导致的。 结论:由于直接测量步行速度或耐力的研究数量有限,无法确切确定远程康复作为一种步行治疗方式的有效性。然而,有强有力的证据表明使用远程康复可改善平衡,这对步行恢复有影响。 影响声明:远程康复似乎是安全、可行的,且具有高依从性。我们的结果突出了使用实时监督进行远程康复的研究有限,以及缺乏关注步行速度和耐力结果的研究,而这些对于全面确定远程康复在步态恢复中的作用是必要的。 系统评价注册号:PROSPERO编号CRD42021238197。
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