{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T22:26:48Z","timestamp":1790980008916,"version":"4.1.0"},"reference-count":41,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2023,12,6]],"date-time":"2023-12-06T00:00:00Z","timestamp":1701820800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Ministry of Health\u2014Ricerca Corrente Reti","award":["RCR-2022-23682290"],"award-info":[{"award-number":["RCR-2022-23682290"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Stroke, a leading cause of long-term disability worldwide, manifests as motor, speech language, and cognitive impairments, necessitating customized rehabilitation strategies. In this context, telerehabilitation (TR) strategies have emerged as promising solutions. In a multi-center longitudinal pilot study, we explored the effects of a multi-domain TR program, comprising physiotherapy, speech therapy, and neuropsychological treatments. In total, 84 stroke survivors (74 analyzed) received 20 tailored sessions per domain, addressing individual impairments and customized to their specific needs. Positive correlations were found between initial motor function, cognitive status, independence in activities of daily living (ADLs), and motor function improvement after TR. A lower initial health-related quality of life (HRQoL) perception hindered progress, but improved ADL independence and overall health status, and reduced depression correlated with a better QoL. Furthermore, post-treatment improvements were observed in the entire sample in terms of fine motor skills, upper-limb functionality, balance, independence, and cognitive impairment. This multi-modal approach shows promise in enhancing stroke rehabilitation and highlights the potential of TR in addressing the complex needs of stroke survivors through a comprehensive support and interdisciplinary collaboration, personalized for each individual\u2019s needs.<\/jats:p>","DOI":"10.3390\/jpm13121692","type":"journal-article","created":{"date-parts":[[2023,12,6]],"date-time":"2023-12-06T03:48:41Z","timestamp":1701834521000},"page":"1692","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Telerehabilitation for Stroke: A Personalized Multi-Domain Approach in a Pilot Study"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4891-5755","authenticated-orcid":false,"given":"Sara","family":"Federico","sequence":"first","affiliation":[{"name":"Laboratory of Healthcare Innovation Technology, IRCCS San Camillo Hospital, 30126 Venice, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luisa","family":"Cacciante","sequence":"additional","affiliation":[{"name":"Laboratory of Healthcare Innovation Technology, IRCCS San Camillo Hospital, 30126 Venice, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9415-4948","authenticated-orcid":false,"given":"Roberto","family":"De Icco","sequence":"additional","affiliation":[{"name":"Department of Brain and Behavioral Science, University of Pavia, 27100 Pavia, Italy"},{"name":"Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Gatti","sequence":"additional","affiliation":[{"name":"Humanitas Clinical and Research Center, IRCCS, Rozzano, 20148 Milan, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20148 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8287-4881","authenticated-orcid":false,"given":"Johanna","family":"Jonsdottir","sequence":"additional","affiliation":[{"name":"IRCCS Fondazione Don Carlo Gnocchi, 20148 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2801-9550","authenticated-orcid":false,"given":"Chiara","family":"Pagliari","sequence":"additional","affiliation":[{"name":"IRCCS Fondazione Don Carlo Gnocchi, 20148 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Franceschini","sequence":"additional","affiliation":[{"name":"Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, 00163 Rome, Italy"},{"name":"Department of Human Sciences and Promotion of the Quality of Life, San Raffaele University, 00163 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2651-8479","authenticated-orcid":false,"given":"Michela","family":"Goffredo","sequence":"additional","affiliation":[{"name":"Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, 00163 Rome, Italy"},{"name":"Department of Human Sciences and Promotion of the Quality of Life, San Raffaele University, 00163 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3861-6858","authenticated-orcid":false,"given":"Matteo","family":"Cioeta","sequence":"additional","affiliation":[{"name":"Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, 00163 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8566-3166","authenticated-orcid":false,"given":"Rocco Salvatore","family":"Calabr\u00f2","sequence":"additional","affiliation":[{"name":"IRCCS Centro Neurolesi \u201cBonino Pulejo\u201d, 98121 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2955-4376","authenticated-orcid":false,"given":"Lorenza","family":"Maistrello","sequence":"additional","affiliation":[{"name":"IRCCS San Camillo Hospital, 30126 Venice, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1609-8060","authenticated-orcid":false,"given":"Andrea","family":"Turolla","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Neuromotor Sciences\u2014DIBINEM, Alma Mater Studiorum Universit\u00e0 di Bologna, 40138 Bologna, Italy"},{"name":"Unit of Occupational Medicine, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5990-5734","authenticated-orcid":false,"given":"Pawel","family":"Kiper","sequence":"additional","affiliation":[{"name":"Laboratory of Healthcare Innovation Technology, IRCCS San Camillo Hospital, 30126 Venice, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of RIN_TR_Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,12,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1177\/17474930211065917","article-title":"World Stroke Organization (WSO): Global Stroke Fact Sheet 2022","volume":"17","author":"Feigin","year":"2022","journal-title":"Int. J. Stroke"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1177\/17474930221123175","article-title":"Global stroke statistics 2022","volume":"17","author":"Thayabaranathan","year":"2022","journal-title":"Int. J. Stroke"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1016\/j.apmr.2018.01.023","article-title":"Virtual Reality for Upper Limb Rehabilitation in Subacute and Chronic Stroke: A Randomized Controlled Trial","volume":"99","author":"Kiper","year":"2018","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e98","DOI":"10.1161\/STR.0000000000000098","article-title":"Guidelines for Adult Stroke Rehabilitation and Recovery: A Guideline for Healthcare Professionals From the American Heart Association\/American Stroke Association","volume":"47","author":"Winstein","year":"2016","journal-title":"Stroke"},{"key":"ref_5","first-page":"19","article-title":"Telerehabilitation: An Adjunct Service Delivery Model for Early Intervention Services","volume":"3","author":"Cason","year":"2011","journal-title":"Int. J. Telerehabilit."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Salvalaggio, S., Cacciante, L., Maistrello, L., and Turolla, A. (2023). Clinical Predictors for Upper Limb Recovery after Stroke Rehabilitation: Retrospective Cohort Study. Healthcare, 11.","DOI":"10.3390\/healthcare11030335"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"267","DOI":"10.3389\/fneur.2015.00267","article-title":"Editorial: Principles Underlying Post-Stroke Recovery of Upper Extremity Sensorimotor Function\u2014A Neuroimaging Perspective","volume":"6","author":"Weder","year":"2015","journal-title":"Front. Neurol."},{"key":"ref_8","unstructured":"REhabilitation and Recovery of peopLE with Aphasia after StrokE (RELEASE) Collaborators (2022). Dosage, Intensity, and Frequency of Language Therapy for Aphasia: A Systematic Review-Based, Individual Participant Data Network Meta-Analysis. Stroke, 53, 956\u2013967."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"634065","DOI":"10.3389\/fneur.2021.634065","article-title":"Recovery of Apraxia of Speech and Aphasia in Patients With Hand Motor Impairment After Stroke","volume":"12","author":"Hybbinette","year":"2021","journal-title":"Front. Neurol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1080\/10749357.2017.1305654","article-title":"Motor recovery in post-stroke patients with aphasia: The role of specific linguistic abilities","volume":"24","author":"Ginex","year":"2017","journal-title":"Top. Stroke Rehabil."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"3445","DOI":"10.1080\/09638288.2020.1752317","article-title":"Motor learning in neurological rehabilitation","volume":"43","author":"Levin","year":"2021","journal-title":"Disabil. Rehabil."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1422","DOI":"10.1016\/j.apmr.2022.03.012","article-title":"Effects of Virtual Reality Rehabilitation Training on Cognitive Function and Activities of Daily Living of Patients With Poststroke Cognitive Impairment: A Systematic Review and Meta-Analysis","volume":"103","author":"Chen","year":"2022","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Parisi, A., Bellinzona, F., Di Lernia, D., Repetto, C., De Gaspari, S., Brizzi, G., Riva, G., and Tuena, C. (2022). Efficacy of Multisensory Technology in Post-Stroke Cognitive Rehabilitation: A Systematic Review. J. Clin. Med., 11.","DOI":"10.3390\/jcm11216324"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1097\/JNN.0000000000000423","article-title":"Virtual Reality and Cognitive Rehabilitation in People With Stroke: An Overview","volume":"51","author":"Maggio","year":"2019","journal-title":"J. Neurosci. Nurs."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"255","DOI":"10.3109\/09638288.2013.788218","article-title":"An enriched environment increases activity in stroke patients undergoing rehabilitation in a mixed rehabilitation unit: A pilot non-randomized controlled trial","volume":"36","author":"Janssen","year":"2014","journal-title":"Disabil. Rehabil."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.physio.2021.05.009","article-title":"Neurophysiological changes accompanying reduction in upper limb motor impairments in response to exercise-based virtual rehabilitation after stroke: Systematic review","volume":"113","author":"Ellis","year":"2021","journal-title":"Physiotherapy"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"jrm00325","DOI":"10.2340\/jrm.v54.2270","article-title":"Compliance with Upper Limb Home-Based Exergaming Interventions for Stroke Patients: A Narrative Review","volume":"54","author":"Gelineau","year":"2022","journal-title":"J. Rehabil. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"106960","DOI":"10.1016\/j.jstrokecerebrovasdis.2022.106960","article-title":"Effects of virtual reality-based telerehabilitation for stroke patients: A systematic review and meta-analysis of randomized controlled trials","volume":"32","author":"Hao","year":"2023","journal-title":"J. Stroke Cerebrovasc. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"3450312","DOI":"10.1155\/2023\/3450312","article-title":"Telerehabilitation for Family Caregivers of Stroke Survivors: A Systematic Review and Meta-Analysis","volume":"2023","author":"Sun","year":"2023","journal-title":"J. Nurs. Manag."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Stephenson, A., Howes, S., Murphy, P.J., Deutsch, J.E., Stokes, M., Pedlow, K., and McDonough, S.M. (2022). Factors influencing the delivery of telerehabilitation for stroke: A systematic review. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0265828"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1177\/1357633X15572201","article-title":"Telerehabilitation and recovery of motor function: A systematic review and meta-analysis","volume":"21","author":"Agostini","year":"2015","journal-title":"J. Telemed. Telecare"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Sharififar, S., Ghasemi, H., Geis, C., Azari, H., Adkins, L., Speight, B., and Vincent, H.K. (2023). Telerehabilitation service impact on physical function and adherence compared to face-to-face rehabilitation in patients with stroke: A systematic review and meta-analysis. PM&R.","DOI":"10.1002\/pmrj.12988"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2306","DOI":"10.1016\/j.jstrokecerebrovasdis.2018.05.013","article-title":"Tele-Rehabilitation after Stroke: An Updated Systematic Review of the Literature","volume":"27","author":"Sarfo","year":"2018","journal-title":"J. Stroke Cerebrovasc. Dis."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1007\/s10072-021-05770-6","article-title":"Cognitive telerehabilitation in neurological patients: Systematic review and meta-analysis","volume":"43","author":"Cacciante","year":"2022","journal-title":"Neurol. Sci."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1177\/0269215519896616","article-title":"The effect of augmented speech-language therapy delivered by telerehabilitation on poststroke aphasia-a pilot randomized controlled trial","volume":"34","author":"Ora","year":"2020","journal-title":"Clin. Rehabil."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"106111","DOI":"10.1016\/j.jcomdis.2021.106111","article-title":"Telerehabilitation for people with aphasia: A systematic review and meta-analysis","volume":"92","author":"Cacciante","year":"2021","journal-title":"J. Commun. Disord."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1177\/1357633X211023353","article-title":"Predicting motor gains with home-based telerehabilitation after stroke","volume":"29","author":"Paik","year":"2021","journal-title":"J. Telemed. Telecare"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"13","DOI":"10.2340\/1650197771331","article-title":"The post-stroke hemiplegic patient. 1. a method for evaluation of physical performance","volume":"7","author":"Leyman","year":"1975","journal-title":"Scand. J. Rehabil. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"386","DOI":"10.5014\/ajot.39.6.386","article-title":"Adult norms for the Box and Block Test of manual dexterity","volume":"39","author":"Mathiowetz","year":"1985","journal-title":"Am. J. Occup. Ther."},{"key":"ref_30","first-page":"291","article-title":"The Aachen Aphasia Test","volume":"42","author":"Huber","year":"1984","journal-title":"Prog. Aphasiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1111\/j.1532-5415.2005.53221.x","article-title":"The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment","volume":"53","author":"Nasreddine","year":"2005","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_32","first-page":"61","article-title":"Functional Evaluation: The Barthel Index","volume":"14","author":"Mahoney","year":"1965","journal-title":"Md. State Med. J."},{"key":"ref_33","unstructured":"Ware, J.E. (1999). The Use of Psychological Testing for Treatment Planning and Outcomes Assessment, Lawrence Erlbaum Associates Publishers. [2nd ed.]."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1001\/archpsyc.1961.01710120031004","article-title":"An Inventory for Measuring Depression","volume":"4","author":"Beck","year":"1961","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Dobson, A.J., and Barnett, A.G. (2008). An Introduction to Generalized Linear Models, CRC Press. [3rd ed.].","DOI":"10.1201\/9780367807849"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1097\/EDE.0b013e3181c30fb2","article-title":"Assessing the performance of prediction models: A framework for traditional and novel measures","volume":"21","author":"Steyerberg","year":"2010","journal-title":"Epidemiology"},{"key":"ref_37","unstructured":"R Core Team (2023). R: A Language and Environment for Statistical Computing, R Foundation for Statistical Computing."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1693","DOI":"10.1016\/S0140-6736(11)60325-5","article-title":"Stroke rehabilitation","volume":"377","author":"Langhorne","year":"2011","journal-title":"Lancet"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"880","DOI":"10.1177\/23969873231191304","article-title":"Motor rehabilitation after stroke: European Stroke Organisation (ESO) consensus-based definition and guiding framework","volume":"8","author":"Kwakkel","year":"2023","journal-title":"Eur. Stroke J."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e13387","DOI":"10.1097\/MD.0000000000013387","article-title":"Therapeutic effects of sensory input training on motor function rehabilitation after stroke","volume":"97","author":"Chen","year":"2018","journal-title":"Medicine"},{"key":"ref_41","first-page":"CD010255","article-title":"Telerehabilitation services for stroke","volume":"1","author":"Laver","year":"2020","journal-title":"Cochrane Database Syst. Rev."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/13\/12\/1692\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:33:55Z","timestamp":1760132035000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/13\/12\/1692"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,6]]},"references-count":41,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["jpm13121692"],"URL":"https:\/\/doi.org\/10.3390\/jpm13121692","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,6]]}}}