Telerehabilitation for Hand Function in Stroke Patients

NCT07666906 | Active Not Recruiting

• 1 other identifier: TUF/EIRB/ 200 /26
• Study Type: interventional
• Target: 48
• Locations: 1 country
• Sites: 1

Brief Summary

Stroke is a leading cause of adult disability worldwide, with upper limb impairment significantly reducing independence. Traditional outpatient rehabilitation poses challenges for patients with mobility limitations, financial constraints, or those living in remote areas. This randomized controlled trial compares the effects of conventional outpatient rehabilitation with and without adjunctive telerehabilitation on hand function and motor recovery in subacute stroke patients. Forty-eight participants will be randomly assigned to two groups: Group A receives conventional outpatient rehabilitation plus home-based telerehabilitation via WhatsApp video calls (30 minutes daily, 5 days/week for 6 weeks), while Group B receives conventional outpatient rehabilitation alone (same dose and content). Outcome measures include the Fugl-Meyer Assessment for Upper Extremity (FMA-UE), Box and Block Test (BBT), and Physical Activity Enjoyment Scale (PACES), assessed at baseline and after 6 weeks.

Conditions

Stroke; Upper Extremity Paresis; Hand Functions

Keywords

Telerehabilitation; Stroke Rehabilitation; Hand Function; Motor Recovery; Subacute Stroke

Outcome Measures

Primary Outcomes (1)

• Change in Upper Extremity Motor Function

  Measured using the Fugl-Meyer Assessment for Upper Extremity (FMA-UE). The FMA-UE is a stroke-specific, performance-based impairment index. It assesses motor functioning of the upper extremity. Scores range from 0 to 66, with higher scores indicating better motor function.

  Baseline (pre-intervention) and 6 weeks (post-intervention)

Secondary Outcomes (2)

• Change in Manual Dexterity

  Baseline (pre-intervention) and 6 weeks (post-intervention)

• Change in Physical Activity Enjoyment

  Baseline (pre-intervention) and 6 weeks (post-intervention)

Study Arms (2)

Telerehabilitation + Conventional Outpatient Rehabilitation

EXPERIMENTAL

Participants receive conventional outpatient rehabilitation (on-site, 30 min/day, 5 days/week, 6 weeks) PLUS home-based telerehabilitation via WhatsApp video calls (same dose). Therapy includes warm-up/proximal activation exercises (shoulder shrugs, scapular retraction, trunk forward lean), task-oriented and strengthening exercises (reaching tasks, grasp and release, object transfers). Equipment includes small objects, balls, and TheraBand.

Other: Telerehabilitation with Conventional Therapy; Other: Conventional Outpatient Rehabilitation

Conventional Outpatient Rehabilitation Alone

ACTIVE COMPARATOR

Participants receive conventional outpatient rehabilitation only (on-site, 30 min/day, 5 days/week, 6 weeks). Therapy content is identical to the experimental group: warm-up/proximal activation exercises, task-oriented and strengthening exercises. A physiotherapist provides direct hands-on supervision, checks accuracy, and adjusts difficulty levels in real time based on participant progress.

Other: Conventional Outpatient Rehabilitation

Interventions

Conventional Outpatient Rehabilitation OTHER

Conventional outpatient rehabilitation is delivered on-site at neuro-physiotherapy outpatient departments of participating hospitals. Sessions run 30 minutes each, five days per week for six weeks, using the same exercise content, dosage, and progression criteria as the telerehabilitation group. Exercise components include: warm-up and proximal activation (shoulder shrugs, scapular retraction, trunk forward lean weight bearing) for 5 minutes, followed by task-oriented and strengthening exercises (reaching tasks, grasp and release, transfer of objects) for 20 minutes. A physiotherapist provides direct hands-on supervision, checks movement accuracy, and adjusts difficulty levels in real-time based on participant progress.

Conventional Outpatient Rehabilitation Alone; Telerehabilitation + Conventional Outpatient Rehabilitation

Telerehabilitation with Conventional Therapy OTHER

Telerehabilitation is delivered via live WhatsApp video chats supervised by a physiotherapist. Each session lasts 30 minutes, five days per week for six weeks. The therapist observes participant setup, provides online verbal assistance, checks movement quality and safety, and modifies compensatory strategies. Participants receive essential equipment (small objects, balls, TheraBand) and an internet data bundle to support connectivity. The therapy protocol is standardized using the Upper Extremity Task Specific Training after Stroke by Lang and Birkenmeier and the Accelerated Skill Attainment Program (Cramer et al., 2019).

Telerehabilitation + Conventional Outpatient Rehabilitation

Eligibility Criteria

• Age: 18 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Subacute stroke patients (time since stroke: 1-6 months)\\n
• Fugl-Meyer Assessment for Upper Extremity score between 22-56\\n
• Box and Block Test score of at least 1 block in 60 seconds at the Screening Visit\\n
• Ability to provide informed consent\\n
• Access to a smartphone with WhatsApp capability (for Group A)

You may not qualify if:

• Any other major existing neurological or psychotic disease (e.g., Parkinson's disease, multiple sclerosis)\\n
• Pregnancy\\n
• Any disease apart from index stroke that noticeably affects arm function of paretic limb\\n
• Cognitive impairment that prevents understanding of instructions\\n
• Upper extremity acute orthopedic conditions\\n
• Medically unstable patients

Sponsors & Collaborators

• University of Faisalabad: lead

Study Sites (1)

The University of Faisalabad

Faisalābad, Punjab Province, 3800, Pakistan

Location

MeSH Terms

Conditions

Stroke; Paresis

Interventions

Telerehabilitation

Condition Hierarchy (Ancestors)

Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Rehabilitation; Aftercare; Continuity of Patient Care; Patient Care; Therapeutics; Health Services; Health Care Facilities Workforce and Services; Telemedicine; Delivery of Health Care; Patient Care Management; Health Services Administration

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: The outcome assessors performing the Fugl-Meyer Assessment, Box and Block Test, and PACES evaluations will be blinded to group allocation. Participants and treating physiotherapists cannot be blinded due to the nature of the intervention.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor, Department of Rehabilitation Sciences

Study Record Dates

• First Submitted: June 18, 2026
• First Posted: June 24, 2026
• Study Start: January 19, 2026
• Primary Completion: July 15, 2026
• Study Completion: July 28, 2026
• Last Updated: July 16, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)