BACKGROUND: Telerehabilitation has been used for several years as an alternative to in-person healthcare services to improve accessibility. The COVID-19 pandemic increased the use of and demand for telerehabilitation services for different health conditions, including stroke. OBJECTIVE: To evaluate the evidence on the effectiveness of physical therapy interventions provided via telerehabilitation for improving stroke outcomes. METHODS: A literature search for primary studies was conducted in seven electronic databases. Each author independently searched for relevant quantitative intervention studies and extracted data from included studies. PEDro scale was used to assess the methodological quality of RCTs. Fixed- and random-effect models were used to estimate standardized mean differences (SMD) and confidence intervals (CI). RESULTS: The review included 16 studies with 629 individuals with stroke. Nine RCTs were included in the meta-analysis. Video conferencing (11/16) was the most common method for delivering telerehabilitation services, and all the interventions included an exercise program. All the included studies showed that physical therapy via telerehabilitation improved at least one stroke-related impairment. The studies showed improvements in outcomes for both groups with no differences in the benefits on motor function (SMD -0.01; 95% CI -0.24 to 0.23; p = 0.96), balance (SMD -0.03; 95% CI -0.30 to 0.24; p = 0.80), and activities of daily living (SMD 0.26; 95% CI -0.10 to 0.62; p = 0.16). However, there was improved mobility in favor of telerehabilitation (SMD 5.36; 95% CI 0.15 to 10.56; p = 0.04). CONCLUSIONS: Physical therapy via telerehabilitation may be as effective as in-person services for improving functional outcomes of stroke, mainly if the intervention includes an exercise program.

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