Efficacy of telerehabilitation for cognitive impairments after brain lesions: a systematic review

Ann Phys Rehabil Med. 2025 Nov 22;69(2):102058. doi: 10.1016/j.rehab.2025.102058. Online ahead of print.

ABSTRACT

BACKGROUND: Brain damage and the cognitive impairment associated with it account for a growing number of people who need rehabilitation care. Only part of them benefit from cognitive rehabilitation today. The use of telerehabilitation could be promising for this population. But there is a lack of evidence in the literature concerning the efficacy of cognitive telerehabilitation on cognitive symptoms.

OBJECTIVE: This systematic literature review aims to summarize and analyze evidence about the efficacy of cognitive telerehabilitation, assessed by language or neuropsychological tests in adults with brain injuries, multiple sclerosis, and Parkinson's disease, compared to face-to-face rehabilitation, sham, or no rehabilitation.

METHODS: Following the PRISMA guidelines, we selected randomized controlled trials from 3 databases (Medline, Cochrane Library, Google Scholar) from March to August 2024. Main data (population, study design, outcomes, type of telerehabilitation, and main results) were extracted.

RESULTS: On a total of 4385 articles screened, 26 met the eligibility criteria, involving 1645 participants. The level of evidence was mostly high according to the PEDro Scale, and the risk of bias (assessed using the Cochrane risk-of-bias tool 2) varied among studies. 16 studies showed some efficacy of cognitive telerehabilitation, mostly among individuals' post-stroke.

DISCUSSION: This study highlights some aspects concerning cognitive telerehabilitation, such as its supervision, dose and intensity, duration, content, participant characteristics, and skills. Results interpretation is limited by heterogeneity in pathologies and methodologies of included studies.

CONCLUSION: According to the literature, cognitive telerehabilitation seems efficient among some adults who have experienced cognitive impairments following cerebral damage. More studies are needed, especially for subacute stroke, cancer-related cognitive impairment, and cerebral tumors.

TRIAL REGISTRATION: PROSPERO database: CRD42024463711.

PMID:41275787 | DOI:10.1016/j.rehab.2025.102058