Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jul 3, 2022
Date Accepted: Nov 14, 2023
Date Submitted to PubMed: Nov 20, 2023
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Effects of Different Telerehabilitation Strategies on Knee Osteoarthritis: Systematic Review and Meta-Analysis
ABSTRACT
Background:
Knee osteoarthritis (OA) is a chronic, degenerative bone and joint disease. Currently, telerehabilitation is more and more widely used in the rehabilitation of knee OA, but the effect of different telerehabilitation strategies on knee OA is not clear.
Objective:
The aim of this systematic review and meta-analysis was to identify telerehabilitation strategies attributing to improvement of pain and physical function outcomes in patients with knee OA.
Methods:
We reviewed and analyzed telerehabilitation strategies from randomized controlled trials (RCTs) comparing telerehabilitation with conventional treatment. For each strategy, we examined whether RCTs that applied the strategy in the telerehabilitation resulted in a significantly improvement of pian or physical function compared with conventional treatment.
Results:
We included 8 RCTs (N = 996) incorporating 9 different telerehabilitation strategies. RCTs that provided telerehabilitation were found to be more effective than conventional treatment on improvement of pain (P = .003, SMD = -0.21, 95% CI -0.35 to -0.07) and physical function (P = .01, SMD = -0.19, 95% CI -0.33 to -0.04). Compared the conventional treatment, the group of RCTs that provided education support (P = .003, SMD = -0.32, 95% CI -0.52 to -0.12), physiotherapy support (P = .008, SMD = -0.20, 95% CI -0.34 to -0.05), and physiotherapist support (P = .002, SMD = -0.25, 95% CI -0.42 to -0.09) were found to be more effective on improvement of pain. Meanwhile, compared the conventional treatment, the group of RCTs that provided education support (P = .002, SMD = -0.32, 95% CI -0.52 to -0.12), physiotherapy support (P = .02, SMD = -0.19, 95% CI -0.35 to -0.14,), and physiotherapist support (P = .01, SMD = -0.21, 95% CI -0.37 to -0.05) were found to be more effective on improvement of physical function.
Conclusions:
Telerehabilitation strategies involving education support, physiotherapy support and physiotherapist support were associated with improvement of pain and physical function outcomes. These strategies should be prioritized in telerehabilitation interventions for the management of patients with knee OA.
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