A study on the knowledge, attitude, and practice regarding home-based Tele-rehabilitation among stroke patients and its influencing factors

Background This study aimed to assess the current knowledge, attitude, and practice (KAP) regarding home-based Tele-rehabilitation (HB-TR) among stroke patients and identify the factors influencing these aspects, providing a reference for optimizing the development and promotion of HB-TR, ultimately supporting patients in achieving high-quality home-based rehabilitation. Methods A cross-sectional survey was conducted among hospitalized stroke patients in the rehabilitation departments of five hospitals in Shanghai from April to July 2025. A self-designed questionnaire was used to collect demographic data and KAP scores. Results A total of 385 valid questionnaires were collected. Among the participants, 258 (67.0%) were male, 308 (80.0%) were over 60 years old, 124 (32.2%) had a disease duration of less than 6 months, and only 46 (11.9%) were completely independent in activities of daily living. The mean scores for KAP dimensions were 12.05 ± 5.699 (possible range: 0–18), 46.27 ± 10.446 (possible range: 13–65), and 23.11 ± 4.794 (possible range: 8–32), respectively. Correlation analysis revealed significant positive correlations between knowledge and attitude (r = 0.389, p < 0.001), knowledge and practice (r = 0.439, p < 0.001), and attitude and practice (r = 0.519, p < 0.001). Multivariate regression analysis indicated that disease duration, presence of underlying medical condition (hypertension, diabetes and heart disease), hobbies, and pre-stroke exercise habits were important factors influencing patients' active practice. Conclusion Although stroke patients generally hold positive attitudes and engage to some extent in home-based telerehabilitation (HB-TR), significant knowledge gaps remain. Future efforts should be based on the "Knowledge-Attitude-Practice" model to implement multi-level, personalized intervention strategies that strengthen targeted education and support. These efforts aim to enhance stroke patients' participation in HB-TR, enabling them to overcome temporal and spatial barriers, access more convenient, efficient, and continuous rehabilitation services, and ultimately improve their quality of life while reducing the burdens on families and society.