Effectiveness of telerehabilitation on motor and respiratory function in duchenne muscular dystrophy: a systematic review and meta-analysis.

Abstract

Duchenne muscular dystrophy (DMD) is a progressive neuromuscular disorder causing muscle degeneration, mobility loss, and respiratory decline. Telerehabilitation (TR) may improve access to physiotherapy. To evaluate the effectiveness of TR in improving motor and respiratory function in individuals with DMD, compared to conventional rehabilitation or no intervention. A systematic review was conducted following PRISMA 2020 guidelines (PROSPERO CRD42024534835). Fourteen studies (3 RCTs, 11 observational) involving 377 participants were included. Interventions lasted 6-12 weeks and used synchronous or asynchronous modalities. Methodological quality was assessed with PEDro and JBI tools, and risk of bias with Cochrane RoB. A meta-analysis was performed for studies reporting 6-minute walk test (6MWT), while other outcomes were narratively synthesized. Meta-analysis of three RCTs showed no significant difference in 6MWT between TR and conventional therapy (MD = 24.6 m; 95% CI = -12.4 to 62.4; <i>p</i> = 0.80). Narrative synthesis indicated TR may improve motor and respiratory function, as well as muscle strength, with moderate risk of bias. Synchronous TR showed more consistent improvements. TR appears feasible and potentially effective as a complement to conventional rehabilitation in DMD. Larger, high-quality trials are needed to confirm long-term efficacy and optimize implementation.