Covarrubias-Escudero F, Balbontín-Miranda F, Urzúa-Soler B, Ciuffardi R, Muñoz M, Hernández V, Appelgren-González J P
Translational Research Unit, Trainfes Center, Santiago, Chile.
Department of Kinesiology, Faculty of art and Physical Education, Universidad Metropolitana de Ciencias de la Educación, Santiago, Chile.
Artif Organs. 2025 Jul;49(7):1141-1152. doi: 10.1111/aor.14922. Epub 2024 Dec 12.
Stroke survivors often face challenges in recovery and reintegration after acute care. Home-based rehabilitation, incorporating advanced technologies like Functional Electrical Stimulation (FES), shows promise for improving long-term outcomes by providing more accessible, high-intensity, and task-oriented rehabilitation outside traditional clinical settings.
This study assessed efficacy and usability of a 10-week home-based rehabilitation protocol for 52 individuals with chronic stroke. The intervention featured a cloud-based platform, a mobile application, and functional electrical stimulation devices. Participants were categorized into groups for tailored exercise training and received both synchronous and asynchronous sessions. Efficacy was measured through standardized motor function tests, while usability was evaluated based on adherence, patient satisfaction, and the frequency of technical support requests.
High adherence (74.03%) and a satisfaction of 73% were observed. On average, patients performed on average 414 min of unsupervised exercise per week. Significant improvement, including a median decrease of 6.08 s (22%) in Timed Up and Go (TUG) [z (24) = 4.17, p < 0.001], a median decrease of 4.04 s (17%) in Five Times Sit to Stand (5STS) [z (28) = 3.96, p < 0.001], Motor Assessment Scale (MAS) showed a mean increase of 3.2 ± 2.8 points, paired t-test [t (20) = -5.01 p < 0.001] and an increase of 0.095 m/s (28%) in 10-Meter Walk Test (10MWT) [z (24) = 3.71, p < 0.001]. Clinical relevance was observed in all outcome measures compared with the reported Minimum Detectable Change.
This evaluation of a home-based physiotherapy protocol indicates that integrating FES devices with virtual platforms and mobile applications can sustain high adherence while improving functional outcomes in chronic stroke rehabilitation. The prescription of high-intensity training, significant improvements in balance, gait, and overall functionality were observed, highlighting the viability of this approach for home-based programs.
中风幸存者在急性护理后的恢复和重新融入过程中常常面临挑战。居家康复结合功能性电刺激（FES）等先进技术，通过在传统临床环境之外提供更易获得、高强度且以任务为导向的康复训练，有望改善长期预后。
本研究评估了一项针对52名慢性中风患者的为期10周的居家康复方案的疗效和可用性。该干预措施包括一个基于云的平台、一个移动应用程序和功能性电刺激设备。参与者被分组进行量身定制的运动训练，并接受同步和异步训练课程。疗效通过标准化运动功能测试进行测量，而可用性则根据依从性、患者满意度和技术支持请求的频率进行评估。
观察到高依从性（74.03%）和73%的满意度。患者平均每周进行414分钟的无监督运动。有显著改善，包括计时起立行走测试（TUG）中位数减少6.08秒（22%）[z(24)=4.17，p<0.001]，五次坐立测试（5STS）中位数减少4.04秒（17%）[z(28)=3.96，p<0.001]，运动评估量表（MAS）平均增加3.2±2.8分，配对t检验[t(20)=-5.01，p<0.001]，10米步行测试（10MWT）增加0.095米/秒（28%）[z(24)=3.71，p<0.001]。与报告的最小可检测变化相比，在所有结局指标中均观察到临床相关性。
这项对居家物理治疗方案的评估表明，将FES设备与虚拟平台和移动应用程序相结合，可以在提高慢性中风康复功能结局的同时保持高依从性。观察到高强度训练的处方、平衡、步态和整体功能的显著改善，突出了这种方法在居家项目中的可行性。
