Review Article

Telerehabilitation for Family Caregivers of Stroke Survivors: A Systematic Review and Meta-Analysis

Table 1

The characteristics of included studies.

Author, yearCountrySample size (EG/CG)Age of patients (EG/CG)Age of caregiver (EG/CG)Interventions (EG/CG)Intervention formatIntervention durationOutcomes
(Mean ± SD)(Mean ± SD)

Radomski, 2007 [18]USAEG: n = 547–72/24–81EG: habit training via a wireless device during a four- to five-week practice periodWeb-based software5 weeksCaregiver burden
CG: n = 5CG: usual and customary practice (received no therapeutic intervention during the home visits)

Pierce et al., 2009 [17]USAEG: n = 3663 ± 15/63 ± 13.354 ± 12.2/55 ± 13.1EG: caring-web intervention: (1) linked websites about stroke care; (2) customized educational information to carers’ needs; (3) an e-mail forum to ask any questions in private; and (4) a nonstructured e-mail discussion amongst all participants facilitated by the nurseWebsite + e-mail12 monthsDepression
CG: n = 37CG: non-web user group

Kim and Park, 2011 [16]KoreaEG: n = 1759.6 ± 9.5/58.5 ± 8.838.3 ± 12.6/42.9 ± 12.0EG: web-based stroke prevention education programWebsite12 weeksCaregiving knowledge
CG: n = 17CG: usual care

Harwood et al., 2012 [25]New ZealandEG: n = 3961.5 ± 13.9/61.3 ± 14.8EG: DVD and take charge session. 80-minute DVD about recovery and 80-minute individualized assessmentDVD12 monthsCaregiver burden
CG: n = 39CG: written materials about stroke for patients and their families

Redzuan et al., 2012 [10]MalaysiaEG: n = 4463.7 ± 12/59.4 ± 11EG: received a video to guide therapy at home. The video consisted of 6 sections and included a 45-minute self-instructional therapy in 2 languagesDVD3 monthsCaregiver burden
CG: n = 46CG: verbal instruction and outpatient appointments once a week

Eames et al., 2013 [27]AustraliaEG: n = 3161.4 ± 12.7/55.2 ± 16.761.4 ± 12.7/55.2 ± 16.7EG: stroke education and support packages were applied to patients and caregivers. Telephone sessions at intervals of approximately 1 month, over a 3-month periodWebsite + telephone sessions3 monthsCaregiver burden; anxiety; depression; self-efficacy; caregiving knowledge
CG: n = 30CG: standard care

Kim et al., 2013 [28]KoreaEG: n = 1867.4 ± 7.3/63.9 ± 7.449.8 ± 14.8)/57.3 ± 11.5EG: the web-based stroke education program included nine video-based lectures within 9 weeksWebsite9 weeksCaregiving competence
CG: n = 18CG: standard care

Blanton, 2016 [24]USAEG: n = 2156.5 ± 12.6)/60.1 ± 14.056.5 ± 12.6)/60.1 ± 14.0EG: CARE-CITE education program carepartners (caregivers participated in online CARE-CITE education while stroke survivors received constraint-induced movement therapy)Website1 monthCaregiver burden; depression; self-efficacy
CG: n = 11CG: traditional education carepartners (carepartners participated in traditional education while the stroke survivor received constraint-induced movement therapy)

Berg et al., 2016 [19]AustraliaEG: n = 3164.5 ± 18.5/70.1 ± 12.4EG: an 8-week caregiver-mediated training program with support using a customized exercise app loaded onto a tabletWeb-based software + video conferencing8 weeksCaregiver burden; self-efficacy
CG: n = 32CG: usual rehabilitation care

Chen et al., 2017 [29]ChinaEG: n = 2766.52 ± 12.08/66.15 ± 12.33EG: the home telesupervising rehabilitation program consisted of a network data system, therapist end, and patient endWeb-based software24 weeksCaregiver burden
CG: n = 27CG: conventional outpatient rehabilitation

Cheng et al., 2018 [30]Hong KongEG: n = 6471.16 ± 11.89/70.59 ± 10.3649.08 ± 12.09/49.11 ± 12.90EG: the psychoeducational program is composed of (1) two structured individual face-to-face stroke education sessions; and (2) six biweekly telephone problem-solving skills training sessions. An information booklet was developed as reference material for caregiversTelephone sessions26 weeksCaregiver burden; depression; caregiving competence
CG: n = 64CG: routine care (interdisciplinary rehabilitation services and postdischarge outpatient medical follow-up)

Kootker et al., 2019 [31]NetherlandsEG: n = 23≥1859.6 ± 10.2/59.8 ± 12.5EG: computerized cognitive training with 13–16 sessions. Each session will take two 20–25 minute-blocks divided by a 10–15 minute-breakWeb-based software4 monthsCaregiver burden; anxiety; depression
CG: n = 27CG: cognitive behavioral therapy augmented with movement or occupational therapy

Vloothuis et al., 2019 [32]NetherlandsEG: n = 3260.53 ± 14.82/59.26 ± 15.0153.91 ± 14.90/54.00 ± 12.26EG: caregiver-mediated exercises at least five times a week for 30 minutesTelephone session + video conferencing + e-mail8 weeksCaregiver burden; anxiety; depression; self-efficacy
CG: n = 34CG: usual care

LeLaurin et al., 2021 [26]USAEG: n = 1370.6 ± 10.760.3 ± 10.1EG: eight-week intervention (the intervention was based on the RESCUE website and delivered via telephone in 8 weekly sessions lasting 30 to 60 minutes each)Website + telephone sessions8 weeksCaregiver burden; depression
CG: n = 14CG: standard care

Woodward et al., 2021 [23]USAEG: n = 54≥1869.8 ± 13.8/58.1 ± 15.5EG: SWCM + MISTT website (the MISTT website included a range of resources and stroke-related information)Website60 daysDepression
CG: n = 58CG: usual care (the health-related brochures were mailed at 1, 4, and 8 week postdischarge)

Zhao et al., 2021 [20]ChinaEG: n = 3862.50 ± 12.02/62.95 ± 10.2143.87 ± 11.35/44.54 ± 11.56EG: Internet combined with information, motivation, and behavior modelWeb-based software + WeChat5 weeksCaregiver burden; caregiving competence; caregiving knowledge
CG: n = 39CG: usual care

Note. EG, experimental group; CG, control group; SD, standard deviation; SWCM, social work case management; MISTT, Michigan stroke transitions trial.