This review assessed and synthesized existing literature on the effectiveness of telerehabilitation as an alternative to conventional in-person physical therapy to improve balance control among older adults.
This review was registered in PROSPERO (ID-CRD42024517316) in February 2024. A literature search was conducted across five databases (PubMed, Cochrane, Science Direct, Sagepub, and PEDro) to include articles from inception until February 10, 2024. Search terms included older adults, telerehabilitation, and balance control. Randomized controlled trials (RCTs) published in English and participated in by individuals with or without medical conditions aged 60 years or above who received telerehabilitation with balance-related outcomes were included. The article retrieval process followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Two reviewers used the JBI Checklist for RCTs to assess study quality. Two researchers extracted data on participant’s characteristics, intervention protocol, outcome measures, and significant findings. The forest plot was used to graphically represent the compounded results of telerehabilitation based on balance outcome measures.
Five eligible studies with sample sizes ranging from 30 to 283 participants aged 67-78 years (68.06% female) were identified. Telerehabilitation was primarily delivered through video calls, with real-time feedback from physical therapists. Balance was measured using the Berg Balance Scale (BBS) and Timed-Up-and-Go Test (TUG). Meta-analyses showed that telerehabilitation is as effective as in-person physical therapy for improving balance control. Although BBS scores slightly favored the in-person physical therapy group, the clinical significance was uncertain due to the variations in the reported minimal clinically important difference (MCID) and confidence intervals. Overall, telerehabilitation emerged as a practical alternative to in-person physical therapy sessions.
Telerehabilitation is a viable alternative as it offers comparable outcomes to traditional in-person physical therapy in improving balance control among older adults. It is neither inferior nor superior to in-person physical therapy sessions.
Despite establishing telerehabilitation as a viable alternative, it is crucial to consider specialized training requirements and financial provisions as prerequisites for successfully implementing it in remote areas. There remains considerable heterogeneity in outcome measures utilized across studies. Subsequent research should employ a larger sample size utilizing consistent balance control outcome measures tailored specifically for telerehabilitation contexts for older persons.
telerehabiliation
balance control
