Effectiveness of real-time visual supervised telerehabilitation on functioning following knee arthroplasty compared with outpatient or home-based exercise: A systematic review of randomized controlled trials.
systematic_review · Level I
Where this comes from
- Record sourced from PubMed, PMID 42305889.
- Also identified by DOI 10.1002/jeo2.70575 and PMC identifier 13266366.
- Licence recorded as CC BY.
- The licence permits redistribution, so the abstract is shown in full and the full text is available from the publisher.
Abstract
With advances in digital healthcare technologies, telerehabilitation has recently been utilized to deliver rehabilitation in real time following orthopaedic surgery; in this scenario, therapeutic exercise, robotic rehabilitation and virtual reality approaches might be tailored to the patient's needs by professionals, utilizing digital smart devices, in a videoconferencing-based approach with a positive impact on the patients. There remains a relative paucity of high-quality research evaluating the effectiveness of real-time visual-supervised telerehabilitation (RTVST) compared to outpatient rehabilitation following total knee arthroplasty (TKA) in the current literature. This systematic review of randomized controlled trials (RCTs) aimed to assess the clinical efficacy of RTVST after TKA in terms of outcomes and knee function using the Western Ontario and McMaster Universities Arthritis Index (WOMAC) compared with outpatient or home-based exercise. PubMed, Scopus and Web of Science databases were systematically searched for English-language RCTs published from 2015 to 2025. Of 577 studies identified, five RCTs were included after screening according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The included studies, conducted across various countries and utilizing diverse telerehabilitation models (e.g., videoconferencing and wearable sensors), consistently suggest that RTVST is a feasible, safe and often noninferior alternative to traditional rehabilitation, with some studies indicating superior or faster functional recovery in specific parameters. RTVST also offered potential benefits in cost-effectiveness. However, limitations such as technological barriers for the elderly and an overall high risk of bias in the included studies were noted. This systematic review demonstrated that RTVST provides comparable functional outcomes and patient-reported improvements to conventional rehabilitation but highlighted the urgent need for further high-quality research with larger sample sizes and standardized telerehabilitation protocols to clarify its precise role and optimize technological applications. N/A.