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Comparison of synchronous telerehabilitation and home-based upper limb resistance exercise programs in people with paraplegia: A randomized, controlled, double-blind study

J Spinal Cord Med. 2026 Jul 22:1-10. doi: 10.1080/10790268.2026.2657701. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the effectiveness of synchronous telerehabilitation-based resistance exercises on upper limb function in people with paraplegia.

SETTING: Rehabilitation interventions were conducted either synchronously via telerehabilitation or through unsupervised home-based programs in participants’ residential environments.

PARTICIPANTS: Twenty-one people with paraplegia, aged 18-60, who were partially or fully wheelchair-dependent and had sufficient upper limb function and access to online communication tools.

INTERVENTIONS: Both groups followed the same resistance exercise program (3 times/week for 6 weeks). The telerehabilitation group performed exercises under real-time remote supervision of a physiotherapist, while the control group completed an unsupervised home-based exercise program.

OUTCOME MEASURES: Primary outcomes included upper limb muscle strength assessed via handheld dynamometry, physical performance measured by the 20-Meter Wheelchair Push Test, and physical activity levels evaluated using the Physical Activity Scale for Individuals with Physical Disabilities.

RESULTS: Significant within-group improvements were observed in the Study Group for shoulder and wrist strength, mobility performance, and physical activity levels (P < 0.01). However, no statistically significant between-group differences were observed post-intervention (P > 0.05).

CONCLUSION: Synchronous telerehabilitation-based resistance exercises significantly enhanced upper limb strength, mobility, and activity levels in people with paraplegia. Comparable post-treatment outcomes between groups suggest that structured home-based exercise programs may also be effective when appropriately designed and supported.Trial registration: ClinicalTrials.gov identifier: NCT07115693.

PMID:42485535 | DOI:10.1080/10790268.2026.2657701

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