Abstract

Background: Tele-neurorehabilitation has emerged as a transformative model integrating neuroplasticity-driven interventions with digital health technologies.
Objective: To systematically evaluate the clinical effectiveness of tele-neurorehabilitation and to propose a conceptual framework linking neuroplasticity mechanisms with remote care delivery.
Methods: A PRISMA-compliant systematic review was conducted across PubMed/MEDLINE, Scopus and Cochrane Library for studies published between January 2015 and January 2025. Randomized controlled trials, controlled studies and systematic reviews evaluating tele-neurorehabilitation in neurological disorders were included. Risk of bias was assessed using the Cochrane RoB 2 tool and ROBINS-I for nonrandomized studies.
Result: Sixty-two studies met inclusion criteria. Tele-neurorehabilitation demonstrated non-inferiority or superiority to conventional rehabilitation in motor outcomes (standardized mean difference 0.38- 0.61), adherence (+20-30%) and patient engagement. Technology-enhanced modalities, including virtual reality, robotics and brain-computer interfaces, provided additive benefits by increasing training intensity and feedback-driven learning.
Conclusion: Tele-neurorehabilitation represents a paradigm shift from episodic, institution-based care toward continuous, personalized and home-centered rehabilitation. Future research should focus on protocol standardization, cost-effectiveness and long-term outcomes.

Keywords:Tele-neurorehabilitation; Neuroplasticity; Digital health; Stroke; Virtual reality; Robotics; Brain computer interface; Home based rehabilitation