JMIR Publications

ABSTRACT

Background:

Knee osteoarthritis (OA) is a chronic, degenerative bone and joint disease. It can lead to major pressure to the quality of life and mental health of patients, and also brings serious economic burden to society. However, it is difficult for patients with knee OA to access rehabilitation when discharging from the hospital. Internet-based rehabilitation is one of the promising telemedicine strategies for the improvement 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 or usual care. 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 or usual care.

Results:

We included 6 RCTs (N = 734) incorporating 8 different telerehabilitation strategies. The duration of the interventions ranged from 1 to 48 weeks, and sample sizes ranged from 20 to 350. The results showed that RCTs that provided telerehabilitation were found to be more effective than conventional treatment on improvement of pain (P = 0.003, SMD = -0.21, 95% CI -0.35 to -0.07), but did not on physical function (P = 0.24, SMD = -0.09, 95% CI -0.25 to 0.06). Furthermore, this systematic review and meta-analysis indicated that there is no significant correlation between different telerehabilitation strategies and the pain and physical function of patients with knee OA.

Conclusions:

This systematic review and meta-analysis showed that telerehabilitation programs could relieve the pain but not physical function for patients with knee OA. These results indicated that telerehabilitation is beneficial for the implementation of home rehabilitation exercises for knee OA patients, thereby reducing the economic burden of health. However, there are limitations in terms of the number of search results and the number of studies that are eligible for this review and meta-analysis. Therefore, results need to be interpreted with caution and more high-quality studies with large samples are needed to focus on the long-term outcomes of telerehabilitation for patients with knee OA to address this limitation.