Effects of telehealth interventions on performing activities of daily living and maintaining balance in stroke survivors: A systematic review and meta‐analysis of randomised controlled studies

Abstract

Background: Stroke is one of the most common causes of disability worldwide. In recent years, diverse telehealth programmes for stroke survivors have suggested that this mode of rehabilitation could improve stroke survivors' abilities to perform activities of daily living (ADLs) and maintain balance. Although increasingly utilised in clinical and community settings, the effectiveness of telehealth interventions in stroke survivors remains inconclusive. This warrants investigation so that telehealth interventions are evidence-based and are not merely modalities of convenience. Aim:To identify the effects of telehealth interventions on the ability to perform ADLs and maintain balance in stroke survivors.Design: A systematic literature review and meta-analysis were conducted in accordance with PRISMA guidelines.Methods: A systematic literature search was performed using seven databases for literature dated up to April 25, 2021. The revised Cochrane risk of bias tool for randomised trials was used to assess the methodological quality of the included studies.A meta-analysis was performed using a random-effects model to calculate the pooled effects of telehealth interventions. Stata 16.0 was used for the statistical analyses.Results: A total of 14 studies with 1,367 participants were included in the analysis.Overall, telehealth interventions were effective in improving stroke survivors' abilities to carry out their ADLs (standardised mean difference: .45; 95% confidence interval:.12 to .78); however, no significant effects were found on balance. Conclusion: Telehealth interventions are beneficial for improving stroke survivors' performance of their ADLs. Future telehealth intervention trials should focus on identifying essential intervention delivery components that facilitate intervention adoption by clinicians and stroke survivors and sustain the positive effects on stroke survivors' performance of their ADLs in different settings.

Effects of telehealth intervention for people with dementia and their carers: A systematic review and meta‐analysis of randomized controlled studies

“…In comparison with routine or usual care (the typical control condition), telehealth interventions yielded significant benefits for persons with dementia (depressive symptoms) as well as for their caregivers (perceived competence). In addition, telehealth interventions show great promise as efficient, cost‐effective, and accessible strategies, which corresponds to past findings that telehealth appears to positively influence not only persons with dementia but also a wide range of other populations (i.e., stroke survivors, victims of heart failure or other cardiovascular diseases, adolescent sexual health, and HIV/AIDS survivors) (Saragih, Imanuel, Osingada, et al, 2021; Saragih, Imanuel, Porta, & Lee, 2021; Saragih, Tarihoran, Batubara, et al, 2021; Valkanova et al, 2017). More importantly, this suggests that including care delivery through telehealth modality may be a viable approach to guarantee continuity of care, address various care needs remotely, and promote favorable patient outcomes.…”

Effects of videoconferencing intervention on stroke survivors: A systematic review and meta‐analysis of randomised controlled studies

“…Within the decade of study, videoconferencing was also the most reliable and proven intervention strategy to improve a stroke survivor's ability to perform ADLs in both the acute and post‐acute settings (Chen et al, 2017; Li et al, 2020; Saywell et al, 2021; Wu et al, 2020). A recent systematic review also reported that videoconferencing interventions significantly improve ‘the performance of ADLs by stroke survivors (Saragih et al, 2021). In line with work by others, these findings suggest that videoconferencing is feasible, acceptable, beneficial, and able to significantly improve the functional performance of stroke survivors (Beit Yosef et al, 2019).…”

Younger Women’s Experiences of Stroke: A Qualitative Study

“…Young stroke survivors endorsed online service delivery as a preferred method to solve the unmet needs of living with stroke (Keating et al, 2021). It has also been suggested that a combination of selfmanagement and telehealth could offer promising interventions (Saragih et al, 2021). Telehealth applications can be particularly helpful for messaging, telephone, video conferencing, and online platforms and these are very applicable for patients at home otherwise limited by time and distance (Anderson et al, 2022;Hwang et al, 2021).…”