Previously submitted to: JMIR Perioperative Medicine (no longer under consideration since Oct 14, 2025)
Date Submitted: Sep 24, 2024
Open Peer Review Period: Oct 22, 2024 - Dec 17, 2024
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Effects of Postoperative Telerehabilitation in Patients with Rotator Cuff Tear: A Systematic Review and Meta-Analysis
ABSTRACT
Background:
Rotator cuff (RC) disorders are the most common cause of shoulder pain, with a prevalence that increases with age. RC tears significantly impact patients' quality of life and pose a substantial economic burden due to high surgical and rehabilitation costs. Traditional in-person rehabilitation can be challenging for many patients due to logistical barriers. Telerehabilitation, which delivers rehabilitation services remotely, has emerged as a potential alternative, yet its effectiveness for postoperative RC repair remains uncertain.
Objective:
The primary aim of our study is to evaluate the effectiveness of telerehabilitation for patients recovering from RC repair surgery.
Methods:
This study followed PRISMA guidelines for systematic reviews and meta-analyses. A comprehensive literature search was conducted across PubMed, EMBASE, MEDLINE, CENTRAL, CINAHL, and Web of Science for English-language publications up to July 1, 2024. Randomized controlled trials (RCTs) evaluating the effectiveness of telerehabilitation's effectiveness for postoperative RC repair were included. Data were extracted on study characteristics, interventions, outcomes, and risk of bias. The primary outcome was the Constant-Murley Shoulder Outcome Score (CM score) ; secondary outcomes included the Disabilities of the Arm, Shoulder, and Hand (DASH) score and, Visual Analogue Scale (VAS). Meta-analyses were conducted using a random-effects model.
Results:
The search yielded 1387 articles, reduced to 925 after excluding duplicates and ineligible records. Screening led to 33 full-text articles, of which 6 met inclusion criteria. The 6 RCTs included 388 participants post-RC repair, with various telerehabilitation interventions such as mobile applications, videotape, telephone calls, and gamification. PEDro scores ranged from 4 to 8 out of 10. Two studies were high risk and four had some concerns according to ROB2. No significant differences were found between telerehabilitation and control groups in CM score, DASH score, and VAS.
Conclusions:
Telerehabilitation is a viable alternative to traditional rehabilitation post-RC repair, showing comparable improvements in functional recovery and pain management. Further research is needed to standardize its implementation and assess long-term effects.
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