Effectiveness of Telehealth for Self-Care in Stroke Survivors: A Systematic Review
DOI:
https://doi.org/10.51143/jksi.v10i2.934Keywords:
Telehealth Mobile health Self-care Self-management Stroke survivorAbstract
Declining self-care ability in stroke survivors impairs recovery and lowers long-term
quality of life. This systematic review evaluates the effectiveness of telehealth interventions
in improving self-care capacity. Based on the PRISMA framework, five databases:
PubMed, Science Direct, Scopus, Sage Journals, and ProQuest were searched for literature
published between 2020-2024. This search returned 387 results, of which 10 randomized
controlled trials were selected and evaluated according to a critical checklist. The results
of this review suggest that self-care telehealth interventions significantly improve physical
(mobility and muscle strength, performance of daily activities) and psychological
components (self-efficacy, depression and anxiety) that constitute a better quality of life.
Telehealth technologies promote autonomy in stroke survivors by remote health
monitoring, and lessen dependence on direct care. Yet, technological barriers and lower
digital literacy in older and/or marginalized populations are challenges that must be
overcome to achieve fair access and impact
References
Agarwal, S., Jalan, M., Hill, R., Pantalone, E., Thrul, J., Sharma, R., … Robinson, K. A. (2025). Framework to assist stakeholders in technology evaluation for recovery (FASTER) to mental health and wellness. BMC Health Services Research, 25(1), 623. https://doi.org/10.1186/s12913-025-12418-0
Babkair, L. A., & Dickson, V. (2017). Abstract TP391: Barriers and facilitators to self care in stroke survivors. Stroke, 48(suppl_1). https://doi.org/10.1161/str.48.suppl_1.tp391
Biswal, B., Gandhi, Y., Singla, D. R., Velleman, R., Zhou, B., Fernandes, L., … Nadkarni, A. (2024). Interventions for improving adherence to psychological treatments for common mental disorders: a systematic review. Cambridge Prisms: Global Mental Health, 11, e83. https://doi.org/10.1017/gmh.2024.94
Cheng, H., Zhong, D. Y., Huang, W. C., Liu, D. L., Ou, X. M., & Yuan, J. (2024). Intervention effect of telemedicine on ischemic stroke: a systematic review and meta-analysis. Medical Data Mining, 7(2), 3–8. https://doi.org/10.53388/MDM202407012
Elliott, E., Bogard, S., & Kohlhoff, J. (2024). “Sustaining NSW families” as a hybrid face-to-face/virtual program: Experiences of clients and clinicians. Public Health Nursing, (July), 1418–1424. https://doi.org/10.1111/phn.13391
Fakes, K., Waller, A., Carey, M., Czerenkowski, J., Nolan, E., Leigh, L., … Sanson-Fisher, R. (2024). Discharge intervention to improve outcomes and web-based portal engagement after stroke and transient ischaemic attack: A randomised controlled trial. Journal of Stroke and Cerebrovascular Diseases, 33(8), 107771. https://doi.org/10.1016/j.jstrokecerebrovasdis.2024.107771
Falaiye, T. A., Okobi, O. E., Ndoh, C. U., & Ubajaka, C. C. (2025). Self-blood pressure monitoring (SBPM) in patients with hypertension and multimorbidity: A Systematic review. Cureus, 17(1), 1–12. https://doi.org/10.7759/cureus.77160
Feigin, V. L., Brainin, M., Norrving, B., Martins, S., Sacco, R. L., Hacke, W., … Lindsay, P. (2025). World Stroke Organization (WSO): Global Stroke Fact Sheet 2025. International Journal of Stroke, 20(2), 132–144. https://doi.org/10.1177/17474930241308142
Fryer, C. E., Luker, J. A., McDonnell, M. N., & Hillier, S. L. (2016). Self management programmes for quality of life in people with stroke. Cochrane Database of Systematic Reviews, 2016(3), e266–e267. https://doi.org/10.1002/14651858.CD010442.pub2
Gauthier, L. V., Nichols-Larsen, D. S., Uswatte, G., Strahl, N., Simeo, M., Proffitt, R., … Borstad, A. (2022). Video game rehabilitation for outpatient stroke (VIGoROUS): A multi-site randomized controlled trial of in-home, self-managed, upper-extremity therapy. EClinicalMedicine, 43, 101239. https://doi.org/10.1016/j.eclinm.2021.101239
Gebreheat, G., Goman, A., & Porter-Armstrong, A. (2024). The use of home-based digital technology to support post-stroke upper limb rehabilitation: A scoping review. Clinical Rehabilitation, 38(1), 60–71. https://doi.org/10.1177/02692155231189257
Griffiths, M., Kontou, E., & Ford, C. (2023). Psychological support after stroke: unmet needs and workforce requirements of clinical neuropsychological provision for optimal rehabilitation outcomes. British Journal of Hospital Medicine, 84(11), 1–8. https://doi.org/10.12968/hmed.2023.0289
Hwang, N.-K., Park, J.-S., & Chang, M.-Y. (2021). Telehealth interventions to support self-management in stroke survivors: A systematic review. Healthcare, 9(4), 472. https://doi.org/10.3390/healthcare9040472
Ignacio, K. H. D., Medrano, J. M. M., Salabi, S. K. U., Logronio, A. J., Factor, S. J. V., Ignacio, S. D., … Diestro, J. D. B. (2023). Impact of post stroke depression and anxiety on health-related quality of life in young Filipino adults. Frontiers in Stroke, 2. https://doi.org/10.3389/fstro.2023.1149406
Jafari-Golestan, N., Hosseini, M., Dalvandi, A., Fallahi-Khoshknab, M., Rahgozar, M., Sharifi, N., & Sidani, S. (2023). Perceived self-care ability among patients with stroke: Concept analysis. International Health Trends and Perspectives, 3(2), 188–203. https://doi.org/10.32920/ihtp.v3i2.1784
Kariasa, I. M., Nurachmah, E., Setyowati, S., & Koestoer, R. A. (2022). The Combination of Sensor Digital Kariasa Early Detection Prototype and Health Education for Self-Management in Preventing Recurrent Ischemic Stroke. SAGE Open Nursing, 8. https://doi.org/10.1177/23779608221143906
Kementerian Kesehatan Republik Indonesia. (2023). Survei kesehatan indonesia (SKI) 2023: Prevalensi penyakit tidak menular dan faktor risikonya. In Survei kesehatan indonesia (SKI) 2023: Prevalensi penyakit tidak menular dan faktor risikonya. Jakarta. Retrieved from https://repository.badankebijakan.kemkes.go.id/id/eprint/5539
Kim, Y., Kim, M., Kim, J., & Song, T.-J. (2024). Smartphone-based speech therapy for poststroke dysarthria: Pilot randomized controlled trial evaluating efficacy and feasibility. Journal of Medical Internet Research, 26(1), e56417. https://doi.org/10.2196/56417
Li, X., He, Y., Wang, D., & Rezaei, M. J. (2024). Stroke rehabilitation: from diagnosis to therapy. Frontiers in Neurology, 15(August), 1–21. https://doi.org/10.3389/fneur.2024.1402729
Lo, S. H. S., Chau, J. P. C., Choi, K. C., Wong, R. Y. M., Kwan, J. C. Y., & Iu, I. H. L. (2023). Health professional- and volunteer-partnered self-management support (COMBO-KEY) to promote self-efficacy and self-management behaviors in people with stroke: A randomized controlled trial. Annals of Behavioral Medicine, 57(10), 866–876. https://doi.org/10.1093/abm/kaad028
Lo, S. H. S., Chau, J. P. C., Lau, A. Y. L., Choi, K. C., Shum, E. W. C., Lee, V. W. Y., … Lam, S. K. Y. (2023). Virtual Multidisciplinary Stroke Care Clinic for Community-Dwelling Stroke Survivors: A Randomized Controlled Trial. Stroke, 54(10), 2482–2490. https://doi.org/10.1161/STROKEAHA.123.043605
McManus, R. J., Smith, A., Temple, E., Yu, L. M., Allen, J., Doogue, R., … Yardley, L. (2024). Self-monitoring of blood pressure following a stroke or transient ischaemic attack (TASMIN5S): a randomised controlled trial. BMC Cardiovascular Disorders, 24(1), 746. https://doi.org/10.1186/s12872-024-04320-0
Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ, 339(jul21 1), b2535–b2535. https://doi.org/10.1136/bmj.b2535
Mulder, M., Nikamp, C. D. M., Prinsen, E. C., Nijland, R. H. M., van Dorp, M., Buurke, J., … van Wegen, E. E. H. (2024). Allied rehabilitation using caregiver-mediated exercises combined with telerehabilitation for stroke (ARMed4Stroke): A randomised controlled trial. Clinical Rehabilitation, 38(10), 1321–1332. https://doi.org/10.1177/02692155241261700
NICE. (2023). Stroke rehabilitation in adults. National Institute for Health and Care Excellence: Clinical Guidelines, (October), 1–73. Retrieved from www.nice.org.uk/guidance/cg162
Norman Burrell, D. (2024). Telehealth technologies, disruptions, and health literacy. Health Economics and Management Review, 5(4), 33–46. https://doi.org/10.61093/hem.2024.4-03
O’Callaghan, G., Fahy, M., Murphy, P., Langhorne, P., Galvin, R., & Horgan, F. (2022). Effectiveness of interventions to support the transition home after acute stroke: a systematic review and meta-analysis. BMC Health Services Research, 22(1), 1095. https://doi.org/10.1186/s12913-022-08473-6
Park, H.-Y., Yeom, I.-S., & Kim, Y.-J. (2023). Telehealth interventions to support self-care of stroke survivors: An integrative review. Heliyon, 9(6), e16430. https://doi.org/10.1016/j.heliyon.2023.e16430
Patola, A., & Tridiyawati, F. (2022). The Effectiveness of soaking the feet in salt water to reduce the degree of edema in pregnant women trimester III. Jurnal Keperawatan Komprehensif (Comprehensive Nursing Journal), 8(2), 203–211. https://doi.org/10.33755/jkk.v8i2.347
Perez, K., Wisniewski, D., Ari, A., Lee, K., Lieneck, C., & Ramamonjiarivelo, Z. (2025). Investigation into application of AI and telemedicine in rural communities: A systematic literature review. Healthcare, 13(3), 324. https://doi.org/10.3390/healthcare13030324
Rahman, M. S., Peng, W., Adams, J., & Sibbritt, D. (2023). The use of self-management strategies for stroke rehabilitation: a scoping review. Topics in Stroke Rehabilitation, 30(6), 552–567. https://doi.org/10.1080/10749357.2022.2127651
Rasyid, A., Pemila, U., Aisah, S., Harris, S., Wiyarta, E., & Fisher, M. (2023). Exploring the self-efficacy and self-care-based stroke care model for risk factor modification in mild-to-moderate stroke patients. Frontiers in Neurology, 14. https://doi.org/10.3389/fneur.2023.1177083
Riegel, B., Jaarsma, T., & Strömberg, A. (2012). A middle-range theory of self-care of chronic illness. Advances in Nursing Science, 35(3), 194–204. https://doi.org/10.1097/ANS.0b013e318261b1ba
Roesner, K., Scheffler, B., Kaehler, M., Schmidt-Maciejewski, B., Boettger, T., & Saal, S. (2024). Effects of physical therapy modalities for motor function, functional recovery, and post-stroke complications in patients with severe stroke: a systematic review update. Systematic Reviews, 13(1), 270. https://doi.org/10.1186/s13643-024-02676-0
Sakakibara, B. M., Lear, S. A., Barr, S. I., Goldsmith, C. H., Schneeberg, A., Silverberg, N. D., … Eng, J. J. (2022). Telehealth coaching to improve self-management for secondary prevention after stroke: A randomized controlled trial of Stroke Coach. International Journal of Stroke, 17(4), 455–464. https://doi.org/10.1177/17474930211017699
Saywell, N. L., Vandal, A. C., Mudge, S., Hale, L., Brown, P., Feigin, V., … Taylor, D. (2021). Telerehabilitation after stroke using readily available technology: A randomized controlled trial. Neurorehabilitation and Neural Repair, 35(1), 88–97. https://doi.org/10.1177/1545968320971765
Senja Shafira, V., Ramadhani, G., & Rachman, I. F. (2024). How digital literacy can drive inclusive progress towards the 2030 SDGs. Advances in Economics & Financial Studies, 2(2), 40–41. https://doi.org/10.60079/aefs.v2i2.260
Shamshiev, A. S., Saduakas, A. Y., Zhakubayev, M. A., Zh, M. A., Demeuov, T. N., Omarkyzy, I., … Davletov, D. K. (2024). Stroke: A comprehensive overview of trends, prevention, and treatment (Literature review). Proceedings of the BSK Conference, 71–81. https://doi.org/10.35805/BSK2024III010
Sun, Y., Liu, C., Zhang, N., Yang, D., Ma, J., Ma, C., & Zhang, X. (2022). Effect of self-management of stroke patients on rehabilitation based on patient-reported outcome. Frontiers in Neuroscience, 16(October), 1–10. https://doi.org/10.3389/fnins.2022.929646
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References
Agarwal, S., Jalan, M., Hill, R., Pantalone, E., Thrul, J., Sharma, R., … Robinson, K. A. (2025). Framework to assist stakeholders in technology evaluation for recovery (FASTER) to mental health and wellness. BMC Health Services Research, 25(1), 623. https://doi.org/10.1186/s12913-025-12418-0
Babkair, L. A., & Dickson, V. (2017). Abstract TP391: Barriers and facilitators to self care in stroke survivors. Stroke, 48(suppl_1). https://doi.org/10.1161/str.48.suppl_1.tp391
Biswal, B., Gandhi, Y., Singla, D. R., Velleman, R., Zhou, B., Fernandes, L., … Nadkarni, A. (2024). Interventions for improving adherence to psychological treatments for common mental disorders: a systematic review. Cambridge Prisms: Global Mental Health, 11, e83. https://doi.org/10.1017/gmh.2024.94
Cheng, H., Zhong, D. Y., Huang, W. C., Liu, D. L., Ou, X. M., & Yuan, J. (2024). Intervention effect of telemedicine on ischemic stroke: a systematic review and meta-analysis. Medical Data Mining, 7(2), 3–8. https://doi.org/10.53388/MDM202407012
Elliott, E., Bogard, S., & Kohlhoff, J. (2024). “Sustaining NSW families” as a hybrid face-to-face/virtual program: Experiences of clients and clinicians. Public Health Nursing, (July), 1418–1424. https://doi.org/10.1111/phn.13391
Fakes, K., Waller, A., Carey, M., Czerenkowski, J., Nolan, E., Leigh, L., … Sanson-Fisher, R. (2024). Discharge intervention to improve outcomes and web-based portal engagement after stroke and transient ischaemic attack: A randomised controlled trial. Journal of Stroke and Cerebrovascular Diseases, 33(8), 107771. https://doi.org/10.1016/j.jstrokecerebrovasdis.2024.107771
Falaiye, T. A., Okobi, O. E., Ndoh, C. U., & Ubajaka, C. C. (2025). Self-blood pressure monitoring (SBPM) in patients with hypertension and multimorbidity: A Systematic review. Cureus, 17(1), 1–12. https://doi.org/10.7759/cureus.77160
Feigin, V. L., Brainin, M., Norrving, B., Martins, S., Sacco, R. L., Hacke, W., … Lindsay, P. (2025). World Stroke Organization (WSO): Global Stroke Fact Sheet 2025. International Journal of Stroke, 20(2), 132–144. https://doi.org/10.1177/17474930241308142
Fryer, C. E., Luker, J. A., McDonnell, M. N., & Hillier, S. L. (2016). Self management programmes for quality of life in people with stroke. Cochrane Database of Systematic Reviews, 2016(3), e266–e267. https://doi.org/10.1002/14651858.CD010442.pub2
Gauthier, L. V., Nichols-Larsen, D. S., Uswatte, G., Strahl, N., Simeo, M., Proffitt, R., … Borstad, A. (2022). Video game rehabilitation for outpatient stroke (VIGoROUS): A multi-site randomized controlled trial of in-home, self-managed, upper-extremity therapy. EClinicalMedicine, 43, 101239. https://doi.org/10.1016/j.eclinm.2021.101239
Gebreheat, G., Goman, A., & Porter-Armstrong, A. (2024). The use of home-based digital technology to support post-stroke upper limb rehabilitation: A scoping review. Clinical Rehabilitation, 38(1), 60–71. https://doi.org/10.1177/02692155231189257
Griffiths, M., Kontou, E., & Ford, C. (2023). Psychological support after stroke: unmet needs and workforce requirements of clinical neuropsychological provision for optimal rehabilitation outcomes. British Journal of Hospital Medicine, 84(11), 1–8. https://doi.org/10.12968/hmed.2023.0289
Hwang, N.-K., Park, J.-S., & Chang, M.-Y. (2021). Telehealth interventions to support self-management in stroke survivors: A systematic review. Healthcare, 9(4), 472. https://doi.org/10.3390/healthcare9040472
Ignacio, K. H. D., Medrano, J. M. M., Salabi, S. K. U., Logronio, A. J., Factor, S. J. V., Ignacio, S. D., … Diestro, J. D. B. (2023). Impact of post stroke depression and anxiety on health-related quality of life in young Filipino adults. Frontiers in Stroke, 2. https://doi.org/10.3389/fstro.2023.1149406
Jafari-Golestan, N., Hosseini, M., Dalvandi, A., Fallahi-Khoshknab, M., Rahgozar, M., Sharifi, N., & Sidani, S. (2023). Perceived self-care ability among patients with stroke: Concept analysis. International Health Trends and Perspectives, 3(2), 188–203. https://doi.org/10.32920/ihtp.v3i2.1784
Kariasa, I. M., Nurachmah, E., Setyowati, S., & Koestoer, R. A. (2022). The Combination of Sensor Digital Kariasa Early Detection Prototype and Health Education for Self-Management in Preventing Recurrent Ischemic Stroke. SAGE Open Nursing, 8. https://doi.org/10.1177/23779608221143906
Kementerian Kesehatan Republik Indonesia. (2023). Survei kesehatan indonesia (SKI) 2023: Prevalensi penyakit tidak menular dan faktor risikonya. In Survei kesehatan indonesia (SKI) 2023: Prevalensi penyakit tidak menular dan faktor risikonya. Jakarta. Retrieved from https://repository.badankebijakan.kemkes.go.id/id/eprint/5539
Kim, Y., Kim, M., Kim, J., & Song, T.-J. (2024). Smartphone-based speech therapy for poststroke dysarthria: Pilot randomized controlled trial evaluating efficacy and feasibility. Journal of Medical Internet Research, 26(1), e56417. https://doi.org/10.2196/56417
Li, X., He, Y., Wang, D., & Rezaei, M. J. (2024). Stroke rehabilitation: from diagnosis to therapy. Frontiers in Neurology, 15(August), 1–21. https://doi.org/10.3389/fneur.2024.1402729
Lo, S. H. S., Chau, J. P. C., Choi, K. C., Wong, R. Y. M., Kwan, J. C. Y., & Iu, I. H. L. (2023). Health professional- and volunteer-partnered self-management support (COMBO-KEY) to promote self-efficacy and self-management behaviors in people with stroke: A randomized controlled trial. Annals of Behavioral Medicine, 57(10), 866–876. https://doi.org/10.1093/abm/kaad028
Lo, S. H. S., Chau, J. P. C., Lau, A. Y. L., Choi, K. C., Shum, E. W. C., Lee, V. W. Y., … Lam, S. K. Y. (2023). Virtual Multidisciplinary Stroke Care Clinic for Community-Dwelling Stroke Survivors: A Randomized Controlled Trial. Stroke, 54(10), 2482–2490. https://doi.org/10.1161/STROKEAHA.123.043605
McManus, R. J., Smith, A., Temple, E., Yu, L. M., Allen, J., Doogue, R., … Yardley, L. (2024). Self-monitoring of blood pressure following a stroke or transient ischaemic attack (TASMIN5S): a randomised controlled trial. BMC Cardiovascular Disorders, 24(1), 746. https://doi.org/10.1186/s12872-024-04320-0
Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ, 339(jul21 1), b2535–b2535. https://doi.org/10.1136/bmj.b2535
Mulder, M., Nikamp, C. D. M., Prinsen, E. C., Nijland, R. H. M., van Dorp, M., Buurke, J., … van Wegen, E. E. H. (2024). Allied rehabilitation using caregiver-mediated exercises combined with telerehabilitation for stroke (ARMed4Stroke): A randomised controlled trial. Clinical Rehabilitation, 38(10), 1321–1332. https://doi.org/10.1177/02692155241261700
NICE. (2023). Stroke rehabilitation in adults. National Institute for Health and Care Excellence: Clinical Guidelines, (October), 1–73. Retrieved from www.nice.org.uk/guidance/cg162
Norman Burrell, D. (2024). Telehealth technologies, disruptions, and health literacy. Health Economics and Management Review, 5(4), 33–46. https://doi.org/10.61093/hem.2024.4-03
O’Callaghan, G., Fahy, M., Murphy, P., Langhorne, P., Galvin, R., & Horgan, F. (2022). Effectiveness of interventions to support the transition home after acute stroke: a systematic review and meta-analysis. BMC Health Services Research, 22(1), 1095. https://doi.org/10.1186/s12913-022-08473-6
Park, H.-Y., Yeom, I.-S., & Kim, Y.-J. (2023). Telehealth interventions to support self-care of stroke survivors: An integrative review. Heliyon, 9(6), e16430. https://doi.org/10.1016/j.heliyon.2023.e16430
Patola, A., & Tridiyawati, F. (2022). The Effectiveness of soaking the feet in salt water to reduce the degree of edema in pregnant women trimester III. Jurnal Keperawatan Komprehensif (Comprehensive Nursing Journal), 8(2), 203–211. https://doi.org/10.33755/jkk.v8i2.347
Perez, K., Wisniewski, D., Ari, A., Lee, K., Lieneck, C., & Ramamonjiarivelo, Z. (2025). Investigation into application of AI and telemedicine in rural communities: A systematic literature review. Healthcare, 13(3), 324. https://doi.org/10.3390/healthcare13030324
Rahman, M. S., Peng, W., Adams, J., & Sibbritt, D. (2023). The use of self-management strategies for stroke rehabilitation: a scoping review. Topics in Stroke Rehabilitation, 30(6), 552–567. https://doi.org/10.1080/10749357.2022.2127651
Rasyid, A., Pemila, U., Aisah, S., Harris, S., Wiyarta, E., & Fisher, M. (2023). Exploring the self-efficacy and self-care-based stroke care model for risk factor modification in mild-to-moderate stroke patients. Frontiers in Neurology, 14. https://doi.org/10.3389/fneur.2023.1177083
Riegel, B., Jaarsma, T., & Strömberg, A. (2012). A middle-range theory of self-care of chronic illness. Advances in Nursing Science, 35(3), 194–204. https://doi.org/10.1097/ANS.0b013e318261b1ba
Roesner, K., Scheffler, B., Kaehler, M., Schmidt-Maciejewski, B., Boettger, T., & Saal, S. (2024). Effects of physical therapy modalities for motor function, functional recovery, and post-stroke complications in patients with severe stroke: a systematic review update. Systematic Reviews, 13(1), 270. https://doi.org/10.1186/s13643-024-02676-0
Sakakibara, B. M., Lear, S. A., Barr, S. I., Goldsmith, C. H., Schneeberg, A., Silverberg, N. D., … Eng, J. J. (2022). Telehealth coaching to improve self-management for secondary prevention after stroke: A randomized controlled trial of Stroke Coach. International Journal of Stroke, 17(4), 455–464. https://doi.org/10.1177/17474930211017699
Saywell, N. L., Vandal, A. C., Mudge, S., Hale, L., Brown, P., Feigin, V., … Taylor, D. (2021). Telerehabilitation after stroke using readily available technology: A randomized controlled trial. Neurorehabilitation and Neural Repair, 35(1), 88–97. https://doi.org/10.1177/1545968320971765
Senja Shafira, V., Ramadhani, G., & Rachman, I. F. (2024). How digital literacy can drive inclusive progress towards the 2030 SDGs. Advances in Economics & Financial Studies, 2(2), 40–41. https://doi.org/10.60079/aefs.v2i2.260
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