Impact of telehealth on stroke survivor–caregiver dyad in at‐home rehabilitation. A systematic review

Aim: To examine studies involving the impact of telerehabilitation (TLR), tele-­ training and tele-­ support on the dyad stroke survivor and caregiver in relation to psychologi- cal, physical, social and health dimensions. Design: A systematic review was conducted. Data Sources: The following electronic databases were consulted until September 2023: PsycInfo, CINAHL, Eric, Ovid, PubMed, Scopus, Cochrane Central and Web of Science. Review Methods: It was conducted and reported following the checklists for Reviews of PRISMA 2020 Checklist. Critical evaluation of the quality of the studies included in the review was performed with the Joanna Briggs Institute Checklists. Data Synthesis: A total of 2290 records were identified after removing duplicates, 501 articles were selected by title and abstract and only 21 met the inclusion criteria. It in- cluded 4 quasi-­ experimental studies, 7 RCTs, 1 cohort study and 9 qualitative studies. The total number of participants between caregivers and stroke survivors was 1697, including 858 stroke survivors and 839 caregivers recruited from 2002 to 2022. For a total of 884 participants who carried out TLR activities in the experimental groups,11 impact domains were identified: cognitive/functional, psychological, caregiver bur- den, social, general health and self-­ efficacy, family function, quality of life, healthcare utilization, preparedness, quality of care and relationship with technology. Conclusions: The results support the application of telehealth in the discharge phase of hospitals and rehabilitation centres for stroke survivors and caregivers. TLR could be considered a substitute for traditional rehabilitation only if it is supported by a tele-learning programme for the caregiver and ongoing technical, computer and health support to satisfy the dyad's needs. Impact: Designing a comprehensive telemedicine programme upon the return home of the dyad involved in the stroke improves the quality of life, functional, psychologi- cal, social, family status, self-­ efficacy, use of health systems and the dyad's prepara- tion for managing the stroke.