Costs and cost effectiveness of the use of telerehabilitation training for upper limb function in people after stroke: A systematic review

ObjectiveTo review the costs and cost-effectiveness of telerehabilitation training for upper limb function in people after stroke.Data SourcesMEDLINE, EconLit, and EMBASE databases were searched for studies published between 2013 and 16 March 2026.MethodsThe review included studies of technology-based rehabilitation programmes for individuals after stroke that evaluated costs or cost-effectiveness. Titles and abstracts were screened, and data were independently extracted by two researchers. Study quality was appraised using the Critical Appraisal Skills Programme (CASP) checklist. Findings were synthesised narratively.ResultsFifteen studies including 963 participants were included. Two studies conducted cost-effectiveness analyses, eight reported cost analyses, and six reported the use of a preference-based measure recommended for cost-effectiveness studies (all used the EQ-5D), with some studies contributing to more than one category. Evidence on costs and cost-effectiveness was mixed, but several studies suggested potential cost savings. Reporting of EQ-5D outcomes was inconsistent across studies.ConclusionsEvidence on the costs of telerehabilitation training for upper limb function primarily focused on therapist time and equipment costs. Few studies included costs associated with equipment maintenance, depreciation, or the need for internet-enabled devices. Reductions in therapist time could offset or exceed technology costs. Further research is needed to evaluate the longer-term costs and cost-effectiveness of telerehabilitation in this population.