JMIR Publications

ABSTRACT

Background:

As a branch of telemedicine, telerehabilitation is defined as the use of remote healthcare methodologies, specifically information and communication technologies, to deliver therapeutic rehabilitation services outside of medical institutions. Telerehabilitation programs utilize communication and information technologies, such as telephones and video conferencing, to facilitate exercise training, self-management education, and health behavior modifications for non-hospitalized patients. In recent years, two previous systematic reviews have examined the effectiveness of telerehabilitation in the recovery of patients with hip fractures. One review concluded that the efficacy of telerehabilitation on postoperative activity capability, the ability to perform ADL, and pain management in inpatients with hip fractures remains uncertain. However, specific measurement tools for hip function, such as the Harris Hip Score (HHS), have not been examined in a systematic review, which may also be crucial for clinical outcomes in patients with hip fracture, as certain clinical domains, such as pain, range of motion, and deformity, are considered. Moreover, the long-term effects of telerehabilitation on postoperative functional recovery in patients with hip fractures have not been investigated.

Objective:

The current systematic review aims to evaluate the long-term effects of telerehabilitation on postoperative functional recovery in older patients with hip fractures.

Methods:

We conducted a comprehensive search of the PubMed, Cochrane Library, EMBASE, and Web of Science databases up to March 31, 2025, for studies related to telerehabilitation for this patient population. A meta-analysis was performed using RevMan 5.3 software.

Results:

A total of nine studies involving 845 patients were included, and five key themes were identified: Harris Hip Score, Short Physical Performance Battery score, Timed Up and Go Test score, Functional Independence Measure score, and Barthel Index score. Current evidence suggests that telerehabilitation may enhance long-term functional recovery following surgery in older patients with hip fractures. However, the strength of this evidence is limited due to the small number and insufficient quality of the included studies.

Conclusions:

Our review found that postoperative telerehabilitation may benefit long-term functional recovery in elderly patients with hip fractures compared to conventional rehabilitation. However, the evidence was weak due to the limited number and the insufficient quality of the included studies. Our findings indicate that telerehabilitation has demonstrated superior long-term effectiveness in functional recovery, as measured by the HHS, TUG, and SPPB. These results are consistent with and extend previous findings that TUG and SPPB were improved at the treatment endpoint of telerehabilitation. Regarding the ability to perform ADL, although telerehabilitation showed a significant effect on the FIM score, the higher heterogeneity affects the reliability of the results. In terms of the BI measurement, our results appear to align with those of a previous review, as no significant difference was found between the telerehabilitation and conventional rehabilitation groups. Clinical Trial: The review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under the registration number CRD 42024498569.