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M. Moutzouri1, A. Stamouli2, G. Gioftsos1
1University of West Attica, Physiotherapy, Athens, Greece, 2Filoktitis Rehabilitation Center, Physiotherapy, Athens, Greece
Background: Technology-assisted rehabilitation programs have lately become an option for patients with chronic conditions such as knee osteoarthritis (OA) to enhance self-management. They are designed as a flexible, user-friendly therapeutic approach of physiotherapy and consultation with the aim of improving quality of life and increasing accessibility of services. This study will systematically review the recent studies investigating the effectiveness of technology-assisted programs for patients with knee OA.
Purpose: The investigation of technology-assisted rehabilitation programs for the monitoring of physical activity and management of knee OA through a systematic review.
Methods: A systematic review (data sources: Medline, Science Direct, Biomed Central, Google Scholar, EMBASE, Scopus, CIHNAL και Physiotherapy Evidence Database) of randomised controlled/clinical trials of technology-assisted rehabilitation for knee OA was conducted by two independent researchers following the PRISMA Guidelines. Key words utilized in combination were: telerehabilitation, telehealth, telephone-, internet-, video- and game-based programs and applications. Methodological quality of the studies was evaluated by utilizing the Physiostherapy Evidence Database (PEDro) scale.
Results: After screening 1435 identified records, 38 studies were eligible and met inclusion criteria for qualitative synthesis (systematic review). The content of the interventions included exercise, education, training and monitoring.Four modes of telerehabilitation service delivery were identified: telephone-based, video-based, sensor-based, and internet–based telerehabilitation. A number of studies used monitors to measure and encourage physical activity. According to PEDro scale, nine studies were of high methodological quality (> 7). Video-based rehabilitation accompanied with telephone- or virtual-based supervision (blended interventions) is considered the most effective mode of technology-assisted rehabilitation. Patient physical function was slightly better and was better maintained through time up to 12-months with self directed blended interventions. Patient compliance with telerehabilitation was enhanced when therapists maintained physiotherapist-patient telecommunication and provided feedback on patients' safety and progress.
Conclusion(s): Findings suggest that technology-assisted rehabilitation effective in the improvement of functionality and pain but not necessarily physical activity. Combination of technology-assisted programs with interactive (virtual- or telephone- or face-to face) support was slightly more favourable.
Implications: Technology-assisted rehabilitation is a promising alternative mode of therapeutic service that can resolve resources and accessibility limitations for this clinical population. Clinical research is needed to further explore these interactive modes of therapeutic service to larger patient samples.
Funding, acknowledgements: State Scholarship Foundation (IKY)
Keywords: telerehabilitation, telehealth, knee osteoarthritis
Topic: Musculoskeletal: lower limb
Did this work require ethics approval? Yes
Institution: University of West Attica
Committee: EHDE Research Ethics Comitee Uniwa
Ethics number: 49238/09-07-2020
All authors, affiliations and abstracts have been published as submitted.
