Telerehabilitation vs face-to-face computer-based cognitive training in stroke patients: a randomized controlled trial

Introduction: Cognitive deficits are common after stroke, significantly affecting functional independence, quality of life, and long-term outcomes. Computer-based cognitive rehabilitation has shown efficacy in improving attention, memory, and executive functions, but access to in-person therapy is often limited. Telerehabilitation can be a practical alternative by enabling participants to perform tailored exercises remotely while clinicians monitor progress. Objectives: This single-blind randomized controlled trial investigated the effectiveness of computer-based cognitive training delivered remotely (telerehabilitation) versus the same intervention delivered face-to-face in subacute post-stroke participants. Methods: Thirty-nine participants were enrolled and randomized into one of the two groups. All participants underwent 3-hours/week rehabilitation over eight weeks using a technology device for cognitive rehabilitation. Cognitive outcomes were assessed at baseline, post-treatment, and two-month follow-up using cognitive tests (Trail Making Test, Rey Auditory Verbal Learning test, Rey-Osterrieth Complex Figure test, Memory with Interference test, and Dual Task), mood and quality of life questionnaires. Results: Comparable improvements in visual attention, verbal and visuo-spatial long-term memory were observed for both groups at post-treatment and follow-up. Working memory and dual-task performances did not show significant changes. Anxiety, depressive symptoms, and quality of life remained unchanged after intervention. Conclusion: These findings suggest that telerehabilitation may yield cognitive improvements similar to those of face-to-face treatment. Nonetheless, telerehabilitation appears to be a feasible and accessible option for post-stroke patients.