A randomized controlled Trial of telerehabilitation intervention for acute ischemic stroke patients Post-Discharge

Abstract

Background

The acute ischemic stroke (AIS) represents a significant contributor to global disability and mortality rates. Effective rehabilitation interventions play a critical role in enhancing patients’ functional recovery and overall quality of life. With the advancement of telemedicine technology, post-discharge telerehabilitation interventions are becoming increasingly feasible, yet their efficacy requires validation through randomized controlled trials (RCT). This study aimed to evaluate the efficacy of a 12-week telerehabilitation program compared to standard post-discharge care in AIS patients.

Methods

This study employed a randomized controlled design, enrolling 200 patients who had been discharged after an AIS. Participants were randomly assigned to either the intervention group or the control group in a 1:1 ratio. The intervention group received a 12-week telerehabilitation program, which included a personalized rehabilitation training plan, regular video consultations, and health education. The control group received standard post-discharge care, which consisted of a rehabilitation manual and biweekly outpatient follow-ups for up to 12 weeks. The primary outcome measure was the Barthel Index, assessing patients’ ability to perform activities of daily living. Secondary outcome measures included the modified Rankin Scale (mRS, assessing the degree of disability), Hamilton Depression Rating Scale (HAMD, assessing the patients’ mental health status), and World Health Organization Quality of Life-BREF (WHOQOL-BREF, assessing the patients’ quality of life).

Results

The mean score of the Barthel Index in the intervention group improved significantly from a baseline of 65.4 ± 12.3 to 88.7 ± 9.6, while the control group improved from 65.6 ± 12.1 to 74.9 ± 13.2 (P < 0.001). The mRS showed that 75 patients (75 %) in the intervention group achieved scores of 0–2 (no symptoms or mild disability), compared to 62 patients (62 %) in the control group, with significant improvement in the intervention group (P = 0.003). The HAMD scores indicated a significant reduction from a baseline of 17.5 ± 4.2 to 9.6 ± 3.1 in the intervention group, compared to a reduction from 17.3 ± 4.0 to 13.2 ± 4.5 in the control group (P < 0.001). The WHOQOL-BREF scores in the intervention group were significantly higher than those in the control group across all four domains: physical health, psychological health, social relationships, and environment (P < 0.05).

Conclusion

The findings of this study support telerehabilitation interventions as an effective rehabilitation method, significantly improving the rehabilitation outcomes and quality of life of patients discharged after mild AIS, and potentially reducing the risk of recurrence.