The effect of telerehabilitation on balance in stroke patients: is it more effective than the traditional rehabilitation model? A meta-analysis of randomized controlled trials published during the COVID-19 pandemic
ObjectiveTelerehabilitation and telemedicine have gradually gained popularity. In 2019, the outbreak of COVID-19 started in Wuhan and then spread across the world. To date, most countries have opted to coexist with the virus. However, patients, especially those who have suffered a stroke, should tak...
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Frontiers Media S.A.
2023-05-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1156473/full |
| _version_ | 1797825460087816192 |
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| author | Zhaoyin Su Zhenxia Guo Weitao Wang Yao Liu Yatao Liu Yatao Liu Wanqiang Chen Maohua Zheng Nerich Michael Shuai Lu Weining Wang Handan Xiao |
| author_facet | Zhaoyin Su Zhenxia Guo Weitao Wang Yao Liu Yatao Liu Yatao Liu Wanqiang Chen Maohua Zheng Nerich Michael Shuai Lu Weining Wang Handan Xiao |
| author_sort | Zhaoyin Su |
| collection | DOAJ |
| description | ObjectiveTelerehabilitation and telemedicine have gradually gained popularity. In 2019, the outbreak of COVID-19 started in Wuhan and then spread across the world. To date, most countries have opted to coexist with the virus. However, patients, especially those who have suffered a stroke, should take measures to avoid being infected with any disease as much as possible since any infectious disease can lead to adverse events for them. Telerehabilitation can be beneficial to stroke patients as they are less likely to be infected by the virus. In recent years, several studies on telerehabilitation have been conducted globally. This meta-analysis aimed to investigate the effects of telerehabilitation on the balance ability of stroke patients, compare the efficacy of conventional rehabilitation with telerehabilitation, explore the characteristics of telerehabilitation and conventional rehabilitation, and provide recommendations for rehabilitation programs in the context of the global pandemic.MethodsWe searched Pubmed, Embase, the Web of Science, and The Cochrane Library databases from 1 January 2020 to 31 December 2022 for randomized controlled trials published in English that evaluated the improvement of balance function in stroke patients after telerehabilitation and compared the differences between telerehabilitation (TR) and conventional rehabilitation (CR). The random-effects model was utilized to calculate mean differences (MDs) with 95% confidence intervals (CIs) to estimate intervention effects. Statistical heterogeneity was assessed according to the I2 values. The risk of bias was measured using the Cochrane risk-of-bias assessment tool.ResultsWe included nine studies in the system evaluation, all of which were included in the pooled analysis. All outcomes in the experimental and control groups improved over time. The comparison between groups concluded that people who received the telerehabilitation intervention had a significant improvement in the Berg Balance Scale (MD = 2.80; 95% CI 0.61, 4.98, P < 0.05, I2 = 51.90%) and the Fugl-Meyer Assessment (MD = 8.12; 95% CI 6.35, 9.88, P < 0.05, I2 = 0) compared to controls. The Timed Up and Go test (MD = −4.59; 95% CI −5.93, –.25, P < 0.05, I2 = 0) and Tinetti Performance-Oriented Mobility Assessment—Balance (MD = 2.50; 95% CI 0.39, 4.61, P < 0.05) scored better in the control group than in the experimental group. There were no significant differences in other outcomes between the two groups.ConclusionStudies on changes in medical conditions during the COVID-19 pandemic also demonstrated that, for stroke patients, telerehabilitation achieves similar effects as the conventional rehabilitation model and can act as a continuation of the conventional rehabilitation model. Owing to the different equipment and intervention programs of telerehabilitation, its curative effect on the static balance and reactive balance of stroke patients may be different. Currently, telerehabilitation may be more conducive to the rehabilitation of patients' static balance abilities, while conventional rehabilitation is more effective for the rehabilitation of patients' reactive balance. Therefore, further studies are needed for investigating the difference in efficacy between varied devices and telerehabilitation programs. Further research is needed on static and reactive balance. In addition, such research should have a large body of literature and a large sample size to support more definitive findings based on the context of the COVID-19 pandemic.Systematic review registrationCRD42023389456. |
| first_indexed | 2024-03-13T10:54:21Z |
| format | Article |
| id | doaj.art-6e1b3ead0a26454fabb662822dc19cd7 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-03-13T10:54:21Z |
| publishDate | 2023-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-6e1b3ead0a26454fabb662822dc19cd72023-05-17T05:33:14ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-05-011410.3389/fneur.2023.11564731156473The effect of telerehabilitation on balance in stroke patients: is it more effective than the traditional rehabilitation model? A meta-analysis of randomized controlled trials published during the COVID-19 pandemicZhaoyin Su0Zhenxia Guo1Weitao Wang2Yao Liu3Yatao Liu4Yatao Liu5Wanqiang Chen6Maohua Zheng7Nerich Michael8Shuai Lu9Weining Wang10Handan Xiao11The First Clinical College of Medicine, Lanzhou University, Lanzhou, ChinaDepartment of Trauma Surgery, First Hospital of Lanzhou University, Lanzhou, ChinaThe First Clinical College of Medicine, Lanzhou University, Lanzhou, ChinaThe First Clinical College of Medicine, Lanzhou University, Lanzhou, ChinaDepartment of Trauma Surgery, First Hospital of Lanzhou University, Lanzhou, ChinaDepartment of Anesthesia Surgery, First Hospital of Lanzhou University, Lanzhou, ChinaDepartment of Rehabilitation, First Hospital of Lanzhou University, Lanzhou, ChinaDepartment of Neurosurgery, First Hospital of Lanzhou University, Lanzhou, ChinaDepartment of Trauma Surgery, University Medical Center Regensburg, Regensburg, GermanyThe First Clinical College of Medicine, Lanzhou University, Lanzhou, ChinaSchool of Stomatology, Lanzhou University, Lanzhou, ChinaThe Second Clinical College of Medicine, Lanzhou University, Lanzhou, ChinaObjectiveTelerehabilitation and telemedicine have gradually gained popularity. In 2019, the outbreak of COVID-19 started in Wuhan and then spread across the world. To date, most countries have opted to coexist with the virus. However, patients, especially those who have suffered a stroke, should take measures to avoid being infected with any disease as much as possible since any infectious disease can lead to adverse events for them. Telerehabilitation can be beneficial to stroke patients as they are less likely to be infected by the virus. In recent years, several studies on telerehabilitation have been conducted globally. This meta-analysis aimed to investigate the effects of telerehabilitation on the balance ability of stroke patients, compare the efficacy of conventional rehabilitation with telerehabilitation, explore the characteristics of telerehabilitation and conventional rehabilitation, and provide recommendations for rehabilitation programs in the context of the global pandemic.MethodsWe searched Pubmed, Embase, the Web of Science, and The Cochrane Library databases from 1 January 2020 to 31 December 2022 for randomized controlled trials published in English that evaluated the improvement of balance function in stroke patients after telerehabilitation and compared the differences between telerehabilitation (TR) and conventional rehabilitation (CR). The random-effects model was utilized to calculate mean differences (MDs) with 95% confidence intervals (CIs) to estimate intervention effects. Statistical heterogeneity was assessed according to the I2 values. The risk of bias was measured using the Cochrane risk-of-bias assessment tool.ResultsWe included nine studies in the system evaluation, all of which were included in the pooled analysis. All outcomes in the experimental and control groups improved over time. The comparison between groups concluded that people who received the telerehabilitation intervention had a significant improvement in the Berg Balance Scale (MD = 2.80; 95% CI 0.61, 4.98, P < 0.05, I2 = 51.90%) and the Fugl-Meyer Assessment (MD = 8.12; 95% CI 6.35, 9.88, P < 0.05, I2 = 0) compared to controls. The Timed Up and Go test (MD = −4.59; 95% CI −5.93, –.25, P < 0.05, I2 = 0) and Tinetti Performance-Oriented Mobility Assessment—Balance (MD = 2.50; 95% CI 0.39, 4.61, P < 0.05) scored better in the control group than in the experimental group. There were no significant differences in other outcomes between the two groups.ConclusionStudies on changes in medical conditions during the COVID-19 pandemic also demonstrated that, for stroke patients, telerehabilitation achieves similar effects as the conventional rehabilitation model and can act as a continuation of the conventional rehabilitation model. Owing to the different equipment and intervention programs of telerehabilitation, its curative effect on the static balance and reactive balance of stroke patients may be different. Currently, telerehabilitation may be more conducive to the rehabilitation of patients' static balance abilities, while conventional rehabilitation is more effective for the rehabilitation of patients' reactive balance. Therefore, further studies are needed for investigating the difference in efficacy between varied devices and telerehabilitation programs. Further research is needed on static and reactive balance. In addition, such research should have a large body of literature and a large sample size to support more definitive findings based on the context of the COVID-19 pandemic.Systematic review registrationCRD42023389456.https://www.frontiersin.org/articles/10.3389/fneur.2023.1156473/fullCOVID-19stroketelerehabilitationmeta-analysisbalancerehabilitation |
| spellingShingle | Zhaoyin Su Zhenxia Guo Weitao Wang Yao Liu Yatao Liu Yatao Liu Wanqiang Chen Maohua Zheng Nerich Michael Shuai Lu Weining Wang Handan Xiao The effect of telerehabilitation on balance in stroke patients: is it more effective than the traditional rehabilitation model? A meta-analysis of randomized controlled trials published during the COVID-19 pandemic Frontiers in Neurology COVID-19 stroke telerehabilitation meta-analysis balance rehabilitation |
| title | The effect of telerehabilitation on balance in stroke patients: is it more effective than the traditional rehabilitation model? A meta-analysis of randomized controlled trials published during the COVID-19 pandemic |
| title_full | The effect of telerehabilitation on balance in stroke patients: is it more effective than the traditional rehabilitation model? A meta-analysis of randomized controlled trials published during the COVID-19 pandemic |
| title_fullStr | The effect of telerehabilitation on balance in stroke patients: is it more effective than the traditional rehabilitation model? A meta-analysis of randomized controlled trials published during the COVID-19 pandemic |
| title_full_unstemmed | The effect of telerehabilitation on balance in stroke patients: is it more effective than the traditional rehabilitation model? A meta-analysis of randomized controlled trials published during the COVID-19 pandemic |
| title_short | The effect of telerehabilitation on balance in stroke patients: is it more effective than the traditional rehabilitation model? A meta-analysis of randomized controlled trials published during the COVID-19 pandemic |
| title_sort | effect of telerehabilitation on balance in stroke patients is it more effective than the traditional rehabilitation model a meta analysis of randomized controlled trials published during the covid 19 pandemic |
| topic | COVID-19 stroke telerehabilitation meta-analysis balance rehabilitation |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1156473/full |
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