Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Nov 26, 2023
Date Accepted: Jul 3, 2024
Telehealth-supported exercise/physical activity programs for knee osteoarthritis: A systematic review and meta-analysis
ABSTRACT
Background:
The integration of telehealth-supported programs in chronic disease management has become increasingly common. However, its effectiveness for individuals with knee osteoarthritis remains unclear.
Objective:
This study aimed to assess the effectiveness of telehealth-supported exercise/physical activity programs for individuals with knee osteoarthritis.
Methods:
A comprehensive literature search encompassing Embase, MEDLINE, CENTRAL, Web of Science, PubMed, Scopus, the Physiotherapy Evidence Database, GreyNet, and medRxiv from inception to September 2023 was conducted to identify randomized controlled trials comparing telehealth-supported exercise/physical activity programs to a control condition for knee osteoarthritis. The systematic review and the meta-analysis protocol were registered with PROSPERO (CRD42022359658) and reported according to PRISMA 2020.
Results:
Twenty-three studies met eligibility criteria, with 20 included in the meta-analysis. Results showed that telehealth-supported exercise/physical activity programs reduced pain (g = −0.39, 95% confidence interval (95%CI) −0.67 to −0.11, P < .01), improved physical activity (g = 0.13, 95%CI 0.03 to 0.23, P = .01), and enhanced physical function (g = −0.51, 95%CI −0.98 to −0.05, P = .03). Moreover, significant improvements in quality of life (g = 0.25; 95% CI 0.14 to 0.36; P <.01), self-efficacy for pain (g = 0.72; 95% CI 0.53 to 0.91; P < .01), and global improvement (odds ratios = 2.69; 95% CI 1.41 to 5.15; P< .01) were observed. However, self-efficacy for physical function (g = 0.14; 95% CI −0.26 to 0.53; P = .50) showed insignificant improvements. Subgroup analyses based on the World Health Organization classification of digital health (pain: χ2 = 6.48, P = .04; physical function: χ2 = 6.44, P = .04), the type of tele-technology in the intervention group (pain: χ2 = 4.76, P = .31; function: χ2 = 12.96, P = .01), and active/inactive controls (pain: χ2 = 5.29, P = .02; physical function: χ2 = 3.37, P = .07) showed significant subgroup differences.
Conclusions:
Telehealth-supported exercise/physical activity programs might reduce knee pain and improve physical activity, physical function, quality of life, self-efficacy, and global improvement in individuals with knee osteoarthritis. Future research should consider longer implementation durations and assess the feasibility of incorporating wearables and standardized components into large-scale interventions to evaluate the effects. Clinical Trial: PROSPERO registration number: CRD42022359658
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