Telerehabilitation for Motor Recovery in Adults with Neurological Disorders: A Systematic Review and Meta-Analysis Across Motor Domains, Delivery Models, and Follow-Up Effects.
Telerehabilitation for Motor Recovery in Adults with Neurological Disorders: A Systematic Review and Meta-Analysis Across Motor Domains, Delivery Models, and Follow-Up Effects.
Where did the research take place?
The study site has not been established. Author addresses may differ from where the research occurred.
Centro, IT · Author affiliation
IRCCS Centro Neurolesi Bonino Pulejo, 98124 Messina, Italy.Location evidence
Messina, IT · Author affiliation
IRCCS Centro Neurolesi Bonino Pulejo, 98124 Messina, Italy.Location evidence
Pune, IN · Author affiliation
Symbiosis College of Physiotherapy, Symbiosis International (Deemed University), Pune 412115, India.Location evidence
Rome, IT · Author affiliation
Research Area in Neuromotor & Robotic Rehabilitation, Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele, 00163 Rome, Italy.Location evidence
Naples, IT · Author affiliation
Department of Mental and Physical Health and Preventive Medicine, University of Campania 'Luigi Vanvitelli', 80138 Naples, Italy.Location evidence
Milan, IT · Author affiliation
IRCCS Fondazione don Carlo Gnocchi ETS, 20148 Milano, Italy.Location evidence
Toronto, CA · Author affiliation
Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, ON M5S 3H2, Canada.Location evidence
Taguig, PH · Author affiliation
Department of Physical Medicine and Rehabilitation, St. Luke's Medical Center, Global City, Taguig 1634, Philippines.Location evidence
Manila, PH · Author affiliation
Department of Rehabilitation Medicine, Philippine General Hospital, Manila 1000, Philippines.Location evidence
Tel Aviv, IL · Author affiliation
Department of Physical Therapy, School of Health Professions, Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv 6997801, Israel.Location evidence
IL · Author affiliation · country only
Multiple Sclerosis Center, Sheba Medical Center, Tel HaShomer 52621, Israel.Location evidence
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Original abstract
Background/Objectives: Telerehabilitation may extend neurorehabilitation beyond conventional settings, but comparative effects across neurological diagnoses and motor domains remain uncertain. This systematic review and meta-analysis synthesized motor outcomes while distinguishing International Classification of Functioning, Disability and Health activity domains, delivery models, and comparator questions. Methods: Five databases were searched from inception to 8 June 2026 using two database-specific Boolean search strategies. Comparative studies of adults with neurological disorders receiving active remote, digital, virtual, wearable, or hybrid rehabilitation were eligible. Random-effects models used restricted maximum likelihood estimation; Hartung-Knapp confidence intervals were primary when at least three studies were available, and DerSimonian-Laird models were sensitivity analyses. Results: Eighty-seven studies included stroke, Parkinson's disease, multiple sclerosis, spinal cord injury, acquired brain injury, or ataxia. For walking and mobility activities versus usual care, no additional therapy, or waitlist, the point estimate favoured telerehabilitation but was imprecise and compatible with no difference (standardized mean difference 1.06, 95% confidence interval -0.23 to 2.35; three studies; 121 participants; I2 = 57.6%). Global motor-functional and activities-of-daily-living outcomes showed similar uncertainty (0.83, -0.35 to 2.00; three studies; 304 participants; I2 = 73.6%). Both findings had very-low-certainty evidence. No pooled comparison included enough studies to assess publication bias. Two-study datasets for balance-related activity/postural control and upper-limb impairment were highly heterogeneous and interpreted descriptively. Conclusions: Comparative evidence for telerehabilitation across neurological diagnoses and motor domains remains uncertain. Programme characteristics are plausible implementation considerations, not established efficacy modifiers. Small evidence sets, wide intervals, clinical heterogeneity, risk of bias, and inconsistent adverse-event ascertainment preclude conclusions about clinical importance or established safety.