Exercises for paretic upper limb after stroke: a combined virtual-reality and telemedicine approach

J Rehabil Med. 2009 Nov;41(12):1016-102. doi: 10.2340/16501977-0459.


Objective: Telerehabilitation enables a remotely controlled programme to be used to treat motor deficits in post-stroke patients. The effects of this telerehabilitation approach were compared with traditional motor rehabilitation methods.

Design: Randomized single-blind controlled trial.

Patients: A total of 36 patients with mild arm motor impairments due to ischaemic stroke in the region of the middle cerebral artery.

Methods: The experimental treatment was a virtual reality-based system delivered via the Internet, which provided motor tasks to the patients from a remote rehabilitation facility. The control group underwent traditional physical therapy for the upper limb. Both treatments were of 4 weeks duration. All patients were assessed one month prior to therapy, at the commencement and termination of therapies and one month post-therapy, with the Fugl-Meyer Upper Extremity, the ABILHAND and the Ashworth scales.

Results: Both rehabilitative therapies significantly improved all outcome scores after treatment, but only the Fugl-Meyer Upper Extremity scale showed differences in the comparison between groups.

Conclusion: Both strategies were effective, but the experimental approach induced better outcomes in motor performance. These results may favour early discharge from hospital sustained by a telerehabilitation programme, with potential beneficial effects on the use of available resources.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Exercise Therapy / methods
  • Female
  • Humans
  • Internet
  • Male
  • Middle Aged
  • Motor Activity / physiology
  • Paresis / physiopathology
  • Paresis / rehabilitation*
  • Recovery of Function
  • Robotics*
  • Single-Blind Method
  • Stroke / physiopathology
  • Stroke Rehabilitation*
  • Telemedicine*
  • Treatment Outcome
  • Upper Extremity / physiopathology*
  • User-Computer Interface*