Telerehabilitation in Postoperative Breast Cancer Care: Systematic Review and Meta-Analysis
Bibliographic record
Abstract
BACKGROUND: Postoperative rehabilitation is essential to improve quality of life (QoL), pain control, and upper limb function in women undergoing surgery for breast cancer (BC). Telerehabilitation has emerged as a promising alternative to conventional rehabilitation, especially in patients with limited access to care, but its comparative efficacy remains uncertain. OBJECTIVE: This study aimed to evaluate the effectiveness of telerehabilitation compared with standard care or no treatment in improving QoL, pain, handgrip strength, and upper limb function in women undergoing BC surgery. METHODS: We conducted a systematic review and meta-analysis following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines. We included 11 randomized controlled trials, of which 5 were eligible for quantitative synthesis. Risk of bias was assessed using the Cochrane risk-of-bias tool for randomized trials version 2 (RoB2), and the certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation approach. Outcomes assessed included QoL, pain, grip strength, and upper limb function. RESULTS: Telerehabilitation significantly improved QoL (standardized mean difference [SMD] 0.59; 95% CI 0.24-0.95; moderate certainty) and grip strength (mean difference [MD] 2.93; 95% CI 0.82-5.04 kg; low certainty), and significantly reduced pain (SMD -0.50; 95% CI -0.79 to -0.22; low certainty). No significant difference was observed for upper limb function (SMD -0.86; 95% CI -2.02 to 0.31; low certainty). CONCLUSIONS: Telerehabilitation is an effective and viable intervention for improving QoL, reducing pain, and enhancing grip strength in women following BC surgery. However, its impact on upper limb function remains inconclusive and requires further investigation. TRIAL REGISTRATION: PROSPERO CRD42024545075; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024545075.
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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 | 0.015 | 0.038 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.018 | 0.039 |
| Bibliometrics | 0.005 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| 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".