This study employed a network meta-analysis to compare the efficacy of five telerehabilitation therapies in improving core symptoms among stroke patients, incorporating 51 randomized controlled trials. Results indicate varying effects across different telerehabilitation modalities for specific functional improvements: Virtual Reality Therapy (TVR) demonstrated superior outcomes in gait enhancement and upper limb functional recovery; Brain-Computer Interface (BCI) achieved optimal results in fine motor control; while exoskeleton rehabilitation training (TERB) proved most effective in enhancing patients' quality of life. This study provides evidence-based guidance for developing personalized telerehabilitation protocols targeting specific rehabilitation goals in clinical practice, facilitating the transition from empirical selection to precision-oriented, goal-directed intervention strategies in telerehabilitation.