Telerehabilitation Improves Balance and Mobility in Chronic Stroke Survivors: Functional Predictors of Health-Related Quality of Life in a Pilot Randomized Controlled Trial

Background: Stroke survivors often experience persistent limitations in mobility and physical function, yet access to rehabilitation is frequently restricted after discharge. Telerehabilitation is a promising alternative, although evidence for structured, group-based formats remains limited. Objective: This study aimed to evaluate the effectiveness of a group-based telerehabilitation program on physical function, psychological well-being, and health-related quality of life (HRQoL) in stroke patients. In addition, we examined whether improvements in physical outcomes predict post-intervention HRQoL. Methods: Thirty-five participants with chronic stroke were randomized into either a telerehabilitation exercise group (n = 18) or a self-exercise rehabilitation group (n = 17). Both groups completed a 16-week home-based program. Outcome measures included the 30-Second Chair Stand Test (30s-CST), Berg Balance Scale (BBS), Timed Up and Go Test (TUG), Korean version of the Falls Efficacy Scale (K-FES), Korean version of the Center for Epidemiologic Studies Depression Scale (K-CES-D), and the EuroQol 5-Dimension 3-Level (EQ-5D-3L) questionnaire. Pre- and post-intervention scores were compared, and linear regression analysis identified predictors of HRQoL. Results: Both groups showed significant within-group improvements. The telerehabilitation group demonstrated superior gains in BBS (p = .010), TUG (p = .020), and EQ-5D-3L scores (p = .035). Group allocation independently predicted improvements in BBS (R² = 0.152) and TUG (R² = 0.153), but not in 30s-CST, K-FES, or EQ-5D-3L. Conclusion: Group-based telerehabilitation led by physical therapists effectively enhances balance, mobility, and perceived health status in individuals with chronic stroke, supporting its use as a feasible alternative to traditional rehabilitation.