Feasibility of Telerehabilitation for Stroke Patients in Remote Areas: Feasibility Study

Abstract

Background:
Stroke survivors living in remote and mountainous regions often face substantial barriers to accessing timely and continuous rehabilitation services. In areas such as Gilgit–Baltistan, geographical isolation, limited specialist availability, and transportation challenges contribute to unmet rehabilitation needs and prolonged disability. Telerehabilitation has emerged as a digital health approach with the potential to bridge these gaps, yet evidence regarding its feasibility in low-resource, remote settings remains limited.

Objective:
To evaluate the feasibility of a structured telerehabilitation program for stroke patients residing in remote areas of Gilgit–Baltistan, with specific focus on acceptability, adherence, safety, and practical implementation.

Methods:
A single-arm feasibility study was conducted over seven months across selected district hospitals and community settings in Gilgit–Baltistan. Forty stroke patients were enrolled, and 32 completed the intervention. Participants received a 12-week individualized telerehabilitation program delivered via video-based sessions. Feasibility outcomes included recruitment, retention, session adherence, technical performance, safety, and usability assessed using the Telehealth Usability Questionnaire. Secondary outcomes included motor recovery (Fugl-Meyer Assessment), balance (Berg Balance Scale), and functional mobility (Timed Up and Go test). Data were analyzed using descriptive statistics and paired sample t-tests.

Results:
The retention rate was 90%, with a mean session adherence of 82.1%. Minor technical issues occurred in 18.4% of sessions and were resolved without discontinuation. No serious adverse events were reported. Telehealth usability scores indicated high acceptability (mean 4.2/5). Significant improvements were observed in motor function (mean increase 11.2 points), balance (mean increase 10.5 points), and mobility (mean reduction 5.8 seconds) following the intervention (p < 0.001).

Conclusion:
Telerehabilitation was feasible, safe, and well accepted among stroke patients in remote areas of Gilgit–Baltistan. The findings support its potential integration into stroke rehabilitation services to improve access and continuity of care in underserved regions.

Keywords:
Access to Care, Digital Health, Rehabilitation, Remote Areas, Stroke, Telemedicine, Telerehabilitation