The Effectiveness of Telerehabilitation in Managing Pain, Strength, and Balance in Adult Patients with Knee Osteoarthritis: A Systematic Review (Preprint)
Notice bibliographique
Résumé
BACKGROUND Knee osteoarthritis (KOA) is a degenerative joint condition characterized by pain, stiffness, and reduced mobility, affecting millions of adults worldwide, especially those over 60. As a leading cause of disability, KOA significantly impacts quality of life. Traditional treatments, including physical therapy and medication, often face barriers related to accessibility, particularly for patients in remote locations or those with limited mobility. Telerehabilitation, which uses digital platforms to deliver therapeutic interventions remotely, has emerged as a promising alternative for managing KOA, offering convenience and continuous care. OBJECTIVE This systematic review aims to evaluate the effectiveness of telerehabilitation in managing pain, strength, and balance in adult patients with knee osteoarthritis. By comparing telerehabilitation with traditional in-person rehabilitation, the review seeks to assess its potential for improving clinical outcomes and its viability as a mainstream treatment option for KOA. METHODS The review focused on randomized controlled trials (RCTs) that evaluated the impact of telerehabilitation on KOA management. A comprehensive search was conducted across databases such as PubMed, PEDro, Cochrane, and Scopus. Eligible studies included adult participants with KOA and compared telerehabilitation interventions with standard rehabilitation methods. The outcomes measured were pain, strength, and balance, assessed using validated tools. Two independent reviewers screened the studies and extracted data, with the quality of the studies assessed using the PEDro scale and the Downs and Black checklist RESULTS Six RCTs involving 581 participants were included in the review. The studies consistently demonstrated that telerehabilitation significantly reduced pain, with patients reporting improvements on scales such as the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Visual Analog Scale (VAS). The effects of telerehabilitation on strength and balance were more varied. Some studies showed significant improvements, particularly in lower body strength and postural balance, while others reported no substantial differences compared to traditional rehabilitation. These discrepancies were likely due to differences in the intervention protocols, patient engagement, and intensity of the rehabilitation programs. CONCLUSIONS Telerehabilitation offers an effective solution for managing knee osteoarthritis, particularly in reducing pain. It presents a viable alternative to in-person therapy, providing flexibility and accessibility for patients who face barriers to traditional rehabilitation. However, its impact on strength and balance needs further investigation to ensure consistency in outcomes. The results suggest that telerehabilitation could be integrated into standard physiotherapy practice, especially for patients who may benefit from remote care. CLINICALTRIAL The a priori protocol for the review is published in the International Prospective Register of Systematic Reviews (PROSPERO): CRD42024564141.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,005 | 0,028 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,007 | 0,008 |
| Bibliométrie | 0,005 | 0,006 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,002 | 0,002 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,002 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».