Hybrid Rehabilitation Models Combining In-Clinic and Home-Based Therapy for Complex Neurological Conditions

Abstract

Hybrid rehabilitation models combining in-clinic and home-based therapy address resource constraints and the heterogeneous needs of patients with complex neurological conditions. Each arm has independent support: telerehabilitation, early supported discharge, and caregiver-mediated exercise carry Cochrane-level evidence, while in-clinic intensity and task-specific training remain standard for motor recovery. No integrative framework, however, prescribes how dose, content, timing, and outcome measurement should be allocated across settings when stroke, traumatic brain injury, progressive disease, and fall risk overlap in a single patient. This paper synthesises fifteen high-quality references and proposes a five-component hybrid framework: phase-gate architecture, dose-allocation logic, caregiver-integration tiers, a remote-capable outcomes battery, and safety guardrails. Application to stroke, polytrauma, progressive neurological disease, and geriatric falls populations is mapped. Implications for civilian home-health physical therapy practice and cost-effectiveness modelling are discussed.