Predictors of Functional Improvement in Patients with Chronic Stroke Participating in Group-Based Telerehabilitation: A Post-hoc Analysis of a Randomized Controlled Trial

Abstract

Objective

Evidence for structured group telerehabilitation in stroke is limited. We evaluated therapist-led group telerehabilitation effects on physical function, psychological well-being, and health-related quality of life (HRQoL) in patients with chronic stroke, and identified functional predictors of improvement.

Methods

Thirty-five patients with chronic stroke were randomized into the telerehabilitation exercise group, referred to as TEG, with eighteen participants, or the self-exercise rehabilitation group, referred to as SRG, with seventeen participants. Outcomes were assessed at baseline and post-intervention. Interaction effects between group and time were evaluated. Significance was set at p < .025 for primary outcomes, Berg Balance Scale (BBS) and Timed Up and Go Test (TUG). Functional predictors were examined via baseline-adjusted regression.

Results

Both groups showed significant within-group improvements (p < .001). Interaction effects revealed statistically significant, though modest, gains in BBS and TUG in the TEG versus SRG. Lower-limb strength, fall efficacy, and depressive symptoms improved over time without significant between-group differences. HRQoL gains were meaningful, especially in the TEG. Regression confirmed group allocation independently predicted balance and mobility improvements (R² = 0.152 and 0.153), with no group effects for other measures.

Conclusion

Real-time, group-based telerehabilitation led by physical therapists serves as a clinically viable alternative that supports functional balance, mobility, and HRQoL in patients with chronic stroke. These findings demonstrate statistically significant improvements in functional outcomes compared with unsupervised exercise, suggesting that this structured remote approach, by providing superior functional benefits over unsupervised exercise, serves as a practical and accessible alternative to traditional facility-based rehabilitation is unavailable.