Author(s): TIGANOS, D., BERGDAHL, A., Institution: CONCORDIA UNIVERSITY , Country: CANADA, Abstract-ID: 662

INTRODUCTION:
Stroke remains a leading cause of long-term disability worldwide, with many survivors experiencing persistent upper-limb impairments [1]. Rehabilitation can improve motor outcomes, yet early care often prioritizes mobility over arm function, contributing to chronic upper-limb deficits after discharge. Access to rehabilitation is frequently limited by transportation, financial constraints, and workforce availability. Telehealth-delivered exercise may help address these barriers; however, the feasibility of supervised upper-limb resistance training delivered via telehealth compared with in-person rehabilitation remains unclear. This study aimed to examine the feasibility and preliminary effects of telehealth-delivered versus in-person upper-limb resistance training in individuals with chronic stroke.
METHODS:
This 8-week feasibility study used randomized allocation to compare in-person versus telehealth-delivered seated upper-limb resistance training in individuals with chronic stroke (greater than 6 months). Fourteen participants (n = 14; mean age 67 +/- 12 years; men and women) were allocated to either in-person or virtual training, all of whom were cleared for exercise. Both groups trained twice weekly for 60-minute sessions, performing task-oriented upper-limb exercises targeting the paretic arm under supervision. Virtual sessions were delivered via live videoconferencing, while in-person sessions were conducted at a community center. Feasibility was assessed through session attendance, and motor outcomes included upper-limb motor function, grip strength, functional reach, dexterity, and quality of life
RESULTS:
Attendance was high in both groups, indicating strong feasibility (in-person: 97.1 +/- 5.3%; virtual: 99.2 +/- 2.5%). Upper-limb motor function improved following the intervention, with mean FM-UE scores increasing from 24.9 +/- 12.3 to 29.6 +/- 12.3 in the in-person group and from 21.0 +/- 12.4 to 24.9 +/- 12.9 in the virtual group (p less than 0.01), with no significant group-by-time interaction (p = 0.44). Grip strength and normalized functional reach also improved over time in both groups (p = 0.001 and p = 0.036, respectively), with comparable patterns of change between delivery formats. Block transfer performance demonstrated a non-significant trend toward improvement (p = 0.06), while quality of life showed small, non-significant improvements.
CONCLUSION:
These findings support the feasibility of supervised telehealth-delivered upper-limb resistance training in individuals with chronic stroke. Telehealth delivery may represent a viable extension of in-person rehabilitation when appropriate supervision is maintained, with potential to improve access to rehabilitation services.

REFERENCES:
1. Feigin VL et al. Global burden of stroke. Lancet Neurology, 2021.