We have now started testing a telehealth system for stroke rehabilitation in a rural area in Sweden (NU- Hospital Group Area). For collection of assessments and audiovisual communication, the telehealth system has bidirectional contact with the home-based units. To date, three stroke subjects’ participated; they were instructed to play 3D computer games with the hemiplegic upper extremity. The intervention led to clinical changes for all subjects. The analysis of the audiovisual communication revealed that the both stroke subjects and therapists were not yet effective in regulating their turn taking process. The data suggests the feasibility of a distance based approach using 3D virtual environments for upper extremity rehabilitation after stroke.