Effectiveness and feasibility of telerehabilitation in patients with COVID-19: a systematic review and meta-analysis

Abstract

ObjectivesTo determine the pooled effectiveness and feasibility of telerehabilitation in patients with COVID-19.DesignSystematic review and meta-analysis of randomised controlled trials (RCTs).Data sourcesPubMed, CINAHL, Science Direct, PEDro, Google Scholar and Cochrane Library databases were systematically searched to the end of March 2022.Eligibility criteria and outcomesRCTs investigating the effects of telerehabilitation in the management of patients with COVID-19 were included. The outcomes of interest were functional capacity, cardiopulmonary exercise tests, quality of life and other variables where data are available.Data extraction and synthesisTwo reviewers screened, extracted data and performed methodological quality assessment independently. The revised Cochrane Risk of Bias tool was used to assess the risk of bias. Review Manager V.5.4 and Stata V.14.0 software were used for statistical analysis. Mean difference (MD) with 95% CI and the corresponding p value were used to determine the treatment effect between groups. A fixed-effect model was used for all variables as no significant heterogeneity was observed.ResultsFour studies with 334 patients with COVID-19 were included. The pooled result of telerehabilitation showed statistically significant improvement on 6-minute walking test (MD 75.50; 95% CI 54.69 to 96.30; p=0.48), 30-second sit-to-stand test (MD 1.76; 95% CI 1.47 to 2.04; p=0.30), Borg Scale (MD 2.49; 95% CI 2.16 to 2.83; p=0.28) and level of dyspnoea (MD 6.26; 95% CI 5.42 to 7.10; p=0.66). The overall treatment completion rate was 88.46%, and the most common reason for withdrawal after randomisation was lost to follow-up or uncooperativeness.ConclusionsThe findings showed that telerehabilitation interventions could improve functional capacity and exercise perception among patients affected by COVID-19 and can be implemented with a high completion rate and minimal adverse events. However, more studies are required to investigate the effects on cardiopulmonary function, quality of life, anxiety, depression and other variables.PROSPERO registration numberCRD42021287975.

Therapeutic Exercise Interventions through Telerehabilitation in Patients with Post COVID-19 Symptoms: A Systematic Review

“…In comparison with traditional rehabilitation, only two studies carried out an analysis of efficacy [31,33], both of which position it as equally effective, and even superior in some parameters such as SGRQ [31]; although more studies are needed on this population, telerehabilitation already has a more than proven efficacy in other pathologies [18,43,44] as well as a much lower cost [45,46] and a good reception by patients [24,47]. These aspects make telerehabilitation a new trend in health sciences and, more specifically, boosted by the COVID-19 pandemic [48].…”

“…During the coronavirus pandemic, the need for maintenance of organ functions through rehabilitation and its continuation has put telerehabilitation programs in a status unusually seen before [13], not only during the acute phase but also in the postviral phase [14][15][16][17][18]. Such telerehabilitation demands and the consequent implementation of physiotherapy staff and training continue to this day [19,20].…”

Home monitoring of coronavirus disease 2019 patients in different phases of disease

“…Forced vital capacity showed an ongoing linear recovery to 19% after 6 months and health status improved [ 21 ]. Monitoring systems for tele-rehabilitation by physiotherapists at home resulted in better physical recovery [ 22 ]. Tele-rehabilitation for pulmonary diseases is discussed in another chapter of this journal.…”

Osteosarcopenia in Patients with Chronic Obstructive Pulmonary Diseases: Which Pathophysiologic Implications for Rehabilitation?

“…In this context, the recent COVID-19 emergency accelerated the spread of technological solutions for healthcare delivery, particularly for frail people considering their needs due to this detrimental disease [ 116 , 117 , 118 ]. Indeed, the COVID pandemic stimulated the telerehabilitation with interesting advantages in overcoming barriers to accessibility and reducing sanitary costs [ 119 , 120 , 121 , 122 ].…”