The Effectiveness of Telerehabilitation in Managing Pain, Strength, and Balance in Adult Patients with Knee Osteoarthritis: A Systematic Review (Preprint)
Bibliographic record
Abstract
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.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.028 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.008 |
| Bibliometrics | 0.005 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".