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Pastora Bernal JM1,2,3, Martín Valero R3, Barón López FJ3, Estebanez Pérez MJ4
1University of Seville, Physiotherapy, Sevilla, Spain, 2EU. Fco Maldonado de Osuna, Physiotherapy, Osuna, Spain, 3University of Malaga, Physiotherapy, Málaga, Spain, 4Grupo Rehab (Private Organization), Physiotherapy, Fuengirola, Spain
Background: The development of new rehabilitation models and practices seems mandatory in order to cope with the change in population needs. Telerehabilitation can help by discharging patients from points of care while improving their adherence to treatment. Telerehabilitation shows promise in many fields, but compelling evidence of benefit and impact on routine rehabilitation programmes is still limited.
Purpose: To investigate the effects of telerehabilitation after surgical procedures in orthopaedic conditions, as well as to describe how interventions are designed and to determine if is comparable to conventional physiotherapy methods
Methods: This review has been carried out following the PRISMA guidelines. Study quality was assessed using the PEDro scores and grade of recommendation following the Oxford center for evidence based medicine. Eligibility criteria include: Adults [⩾ 18 years] with telerehabilitation services after surgical procedures. Any treatment provided via telerehabilitation, phone counselling, interactive virtual system and gaming. All trials were required to have a comparison group with face-to-face treatment or usual physiotherapy care. Any clinical outcome, including pain, quality of life, disability or function were analyzed. All types of study design were considered. A subgroup analysis by population and intervention were conducted
Results: A total of 1316 participants receive telerehabilitation intervention in the studies selected. We found strong evidence for telerehabilitation in patients following total knee arthroplasty and hip replacement. Only one study in the upper limb present moderate grade of evidence and rest are poor methodological quality with weak evidence. The subgroup analysis by population show a predominance [75%] of studies in lower limb. In the subgroup analysis by intervention we found strong evidence regardless of the intervention.
Conclusion(s): Conclusive evidence on the efficacy of telerehabilitation for treatment after orthopaedic surgery, regardless of pathology, was not reached. There is still a very small database for telerehabilitation studies after surgical procedures that provide useful data on clinical outcomes especially in other conditions than the replacement of joints in the lower limb. We found a great heterogeneity regarding sample size ranges, interventions, compared intervention, duration and follow-up periods creating doubts to identify whether the telerehabilitation proves that gives equal or better results or the positive results are related to a more elaborate program than the interventions method.
Implications: Telerehabilitation solutions represent an opportunity to define new social policies and physiotherapy intervention. Powerful methodological quality studies should be conducted to confirm clinically relevant outcomes after surgery in orthopaedic injuries whether pathologies. Telerehabilitation appears to be effective alternative to face-to-face service delivery after hospital discharge of patients following total knee arthroplasty and hip replacement. Despite some limitations, there seem to be clear benefits from physiotherapy at a distance with a telerehabilitation technique whether offers [videoconferencing, phone intervention, asynchronous video exercise programs or gaming]. Future challenges is to expand telerehabilitation services in routine care and identify if positive results are due to the type of intervention or the increased frequency and intensity that telerehabilitation allow
Keywords: Telerehabilitation, Orthopaedic Surgery, Musculoskeletal disorders
Funding acknowledgements: No funding support
Purpose: To investigate the effects of telerehabilitation after surgical procedures in orthopaedic conditions, as well as to describe how interventions are designed and to determine if is comparable to conventional physiotherapy methods
Methods: This review has been carried out following the PRISMA guidelines. Study quality was assessed using the PEDro scores and grade of recommendation following the Oxford center for evidence based medicine. Eligibility criteria include: Adults [⩾ 18 years] with telerehabilitation services after surgical procedures. Any treatment provided via telerehabilitation, phone counselling, interactive virtual system and gaming. All trials were required to have a comparison group with face-to-face treatment or usual physiotherapy care. Any clinical outcome, including pain, quality of life, disability or function were analyzed. All types of study design were considered. A subgroup analysis by population and intervention were conducted
Results: A total of 1316 participants receive telerehabilitation intervention in the studies selected. We found strong evidence for telerehabilitation in patients following total knee arthroplasty and hip replacement. Only one study in the upper limb present moderate grade of evidence and rest are poor methodological quality with weak evidence. The subgroup analysis by population show a predominance [75%] of studies in lower limb. In the subgroup analysis by intervention we found strong evidence regardless of the intervention.
Conclusion(s): Conclusive evidence on the efficacy of telerehabilitation for treatment after orthopaedic surgery, regardless of pathology, was not reached. There is still a very small database for telerehabilitation studies after surgical procedures that provide useful data on clinical outcomes especially in other conditions than the replacement of joints in the lower limb. We found a great heterogeneity regarding sample size ranges, interventions, compared intervention, duration and follow-up periods creating doubts to identify whether the telerehabilitation proves that gives equal or better results or the positive results are related to a more elaborate program than the interventions method.
Implications: Telerehabilitation solutions represent an opportunity to define new social policies and physiotherapy intervention. Powerful methodological quality studies should be conducted to confirm clinically relevant outcomes after surgery in orthopaedic injuries whether pathologies. Telerehabilitation appears to be effective alternative to face-to-face service delivery after hospital discharge of patients following total knee arthroplasty and hip replacement. Despite some limitations, there seem to be clear benefits from physiotherapy at a distance with a telerehabilitation technique whether offers [videoconferencing, phone intervention, asynchronous video exercise programs or gaming]. Future challenges is to expand telerehabilitation services in routine care and identify if positive results are due to the type of intervention or the increased frequency and intensity that telerehabilitation allow
Keywords: Telerehabilitation, Orthopaedic Surgery, Musculoskeletal disorders
Funding acknowledgements: No funding support
Topic: Robotics & technology; Orthopaedics; Musculoskeletal
Ethics approval required: No
Institution: WCPT
Ethics committee: WCPT
Reason not required: Ethical approval is unlikely to have been required if your work: Systematic Review
All authors, affiliations and abstracts have been published as submitted.
