The efficacy of home-based remote rehabilitation versus usual rehabilitation for patients with knee osteoarthritis: A systematic review and meta-analysis.

Abstract

To compare home-based remote rehabilitation with usual rehabilitation care for knee osteoarthritis (OA). PubMed, Cochrane, and Embase databases were searched for randomized controlled trials (RCTs) comparing home-based remote rehabilitation (telephone calls, video calls, apps, or websites) with usual in-person rehabilitation in patients with knee OA. Mean differences (MDs) or standardized mean differences (SMDs) were calculated for continuous outcomes and risk ratios (RRs) for binary outcomes, with 95 % confidence intervals (CIs). Statistical analyses were performed using R Software, version 4.4.1. A total of 9 RCTs were included, comprising 974 patients with knee OA, of whom 483 (49.6 %) were randomized to home-based remote rehabilitation. Compared with usual rehabilitation, home-based remote rehabilitation significantly reduced pain severity (SMD -0.34; 95 % CI -0.67 to -0.02) and significantly improved physical activity levels (SMD -0.45; 95 % CI -0.85 to -0.05). Furthermore, the home-based remote rehabilitation group showed a significant reduction in pain assessed with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) (MD -0.95 points; 95 % CI -1.84 to -0.06), an improvement in functionality assessed with the Timed Up and Go test (MD -0.83 s; 95 % CI -1.64 to -0.02), and a greater patient satisfaction (RR 2.01; 95 % CI 1.46 to 2.76). The results demonstrated that home-based remote rehabilitation reduced pain and increased patient satisfaction, however, there is insufficient evidence to state that remote rehabilitation significantly improved physical activity and functionality. Home-based remote rehabilitation appears to be a viable and effective alternative for patients with knee OA.