The effectiveness of telerehabilitation in patients after total knee replacement: A systematic review and meta-analysis of randomized controlled trials

Abstract

Background Total knee replacement is a commonly adopted surgical intervention to reduce physical limitations and pain in advanced-stage knee osteoarthritis. However, these patients may experience physical dysfunction to limit their access during conventional rehabilitation after total knee replacement. The use of telemedicine may be the promising solution. This study aims to compare the effectiveness of telerehabilitation with conventional in-person rehabilitation in patients who underwent a total knee replacement. Methods For this systematic review on randomized controlled trials, PubMed, Medline, EMBASE, Cochrane Library, ScienceDirect and CINAHL databases were searched for eligible articles published between 1 January 2003 and 28 February 2022. The eligibility criteria were patients who underwent total knee replacement, randomized controlled trials and publications in English. The main outcome measures were focused on pain and physical function. Reference lists of relevant studies were also manually checked to find additional studies. Two independent reviewers conducted study selection separately. PEDro scale was used to assess the methodological quality of the included randomized controlled trials. A meta-analysis was performed on the collected data. Review Manager (RevMan, version 5.3) was used for all analyses. Results A total of 11 studies met the eligibility criteria and included 1825 participants in the systematic review. Overall, the results revealed that the effectiveness of telerehabilitation is comparable to conventional in-person rehabilitation in improving various pain and functional outcomes in patients who underwent a total knee replacement. In the meta-analysis with the fixed-effects model, no significant difference was found in the improvement of pain and physical function in patients with knee osteoarthritis compared with conventional rehabilitation (Standardized Mean Difference (SMD) –0.15, 95% CI −0.47 to 0.16, P = 0.34 and SMD –0.04, 95% CI −0.19 to 0.12, P = 0.62, respectively). In addition, the utilization of hospital resources and costs were significantly lower in telerehabilitation when compared with in-person rehabilitation. Conclusion Telerehabilitation was comparable to conventional in-person rehabilitation in improving clinical outcomes following total knee replacement. However, it might be a more preferable alternative rehabilitation intervention for patients following total knee replacement given the significantly lower cost of telerehabilitation.

Scaled TelePhysical Therapy Program a Promising Option for Post-acute Care of Lower-Extremity Arthroplasty Patients

“…We observed some differences between the LOS groups (age, sex, RAPT scores), but patients achieved clinically meaningful improvements and positive results for all outcome measures, regardless of hospital LOS. This study supports TelePT as a potential option and aligns with evidence suggesting that TelePT can be comparable to in-person care with lower costs [14,22].…”

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].…”

The Efficacy and Safety of Telerehabilitation for Fibromyalgia: Systematic Review and Meta-analysis of Randomized Controlled Trials

“…More importantly, telerehabilitation can overcome geographical barriers and provide medical care services to people in rural and remote communities and patients with fibromyalgia who cannot attend traditional face-to-face rehabilitation services, which is especially essential during the COVID-19 pandemic [ 39 ]. In addition, although none of the included studies in this meta-analysis reported cost-effectiveness, several previous studies have demonstrated that telerehabilitation can reduce the monetary and time costs of rehabilitation services [ 40 , 41 ].…”