What question did this study set out to answer?

This trial aimed to evaluate the non-inferiority of synchronous multi-domain telerehabilitation compared to conventional outpatient therapy in stroke survivors.

May 5, 2026

Efficacy of Multi-Domain Telerehabilitation in Patients with Stroke: A Non-Inferiority, Single-Blind, Randomized Controlled Trial.

Key Points

This trial aimed to evaluate the non-inferiority of synchronous multi-domain telerehabilitation compared to conventional outpatient therapy in stroke survivors.
Randomized controlled trial with 56 stroke survivors.
Participants received either home-based telerehabilitation or conventional outpatient therapy over 20 sessions in four weeks.
Evaluated multiple outcomes including motor, cognitive, and language capabilities.
Telerehabilitation demonstrated non-inferiority in upper-extremity motor scores, with adjusted differences indicating no significant decline.
No significant between-group differences were seen for language and cognitive outcomes.
One-month follow-up showed consistent results with initial findings.

Abstract

ObjectiveAlthough telerehabilitation has emerged as a promising and accessible alternative to traditional in-person therapy, robust evidence supporting its clinical effectiveness across multiple functional domains remains limited. We tested the non-inferiority of synchronous multi-domain telerehabilitation for motor, cognitive, language, and disability outcomes in stroke survivors.DesignBicentric, single-blind (assessor-blinded), randomized controlled non-inferiority trial.MethodsFifty-six participants were randomized to home-based telerehabilitation or conventional outpatient therapy. Both groups completed twenty real-time supervised sessions over four weeks. The primary outcome was change in Fugl-Meyer Assessment upper-extremity motor score (0-66); secondary outcomes included Fugl-Meyer Assessment lower-extremity motor (0-34), Aachen Aphasia Test (Italian version) naming/written language/comprehension, Oxford Cognitive Screen orientation and memory subtests, and Barthel Index. Non-inferiority was evaluated using a prespecified margin (Δ=-5.2) and confidence-interval-based linear mixed-effects models (per-protocol primary, intention-to-treat sensitivity); non-inferiority was concluded if the lower bound of the 95% CI for the adjusted between-group contrast at T1 (telerehabilitation minus conventional) was > -Δ.ResultsThe adjusted between-group difference in change for the primary outcome was compatible with non-inferiority at post-treatment, with consistent results in sensitivity analyses. No significant between-group differences were observed in language, cognitive, or functional independence outcomes, and findings were similar at one-month follow-up.ConclusionsSynchronous multi-domain telerehabilitation appears feasible and yields short-term motor recovery comparable to standard outpatient rehabilitation within a prespecified non-inferiority framework. Interpretation is limited by the short follow-up and restricted cognitive outcome coverage.

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