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      Home-based tele-rehabilitation versus hospital-based outpatient rehabilitation for pain and function after initial total knee arthroplasty: A systematic review and meta-analysis

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          Abstract

          Background:

          This systematic review and meta-analysis aims to compare the effectiveness of home-based tele-rehabilitation programs with hospital-based rehabilitation programs in improving pain and function at various time points (≤6 weeks, ≤14 weeks, and ≤ 52 weeks) following the initial total knee arthroplasty.

          Methods:

          This study used PRISMA and AMSTAR reporting guidelines. We systematically searched 5 databases (PubMed, Embase, Web of Science, Cochrane Library, and Medline) to identify randomized controlled trials published from January 1, 2019, to January 1, 2023. The primary outcomes were pain, knee injury and osteoarthritis outcome score, and mobility (knee range of motion).

          Results:

          We included 9 studies involving 1944 patients. Low-quality evidence showed hospital-based rehabilitation was better than home-based tele-rehabilitation in knee injury and osteoarthritis outcome score (mean difference [MD], −2.62; 95% confidence interval [CI], −4.65 to −0.58; P = .01) at ≤ 14 weeks after total knee arthroplasty. Based on low-quality evidence, home-based tele-rehabilitation was better than hospital-based rehabilitation in knee range of motion (MD, 2.00; 95% CI, 0.60 to 3.40; P = .005). There was no significant difference between hospital-based rehabilitation and home-based tele-rehabilitation in knee pain at ≤ 6 weeks (MD, 0.18; 95% CI, −0.07 to 0.42; P = .16), 14 weeks (MD, 0.12; 95% CI, −0.26 to 0.49; P = .54), and ≤ 52 weeks (MD, 0.16; 95% CI, −0.11 to 0.43; P = .24).

          Conclusion:

          Home-based tele-rehabilitation and hospital-based rehabilitation programs showed comparable long-term outcomes in pain, mobility, physical function, and patient-reported health status after primary total knee arthroplasty. Considering the economic costs, home-based tele-rehabilitation programs are recommended as a viable alternative to hospital-based rehabilitation programs.

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          Most cited references27

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          RoB 2: a revised tool for assessing risk of bias in randomised trials

          Jonathan A C Sterne, Jelena Savović, Matthew J L Page … (2022)
          Article 0 comments Cited 5614 times – based on 0 reviews     Review now
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            The PRISMA 2020 statement: An updated guideline for reporting systematic reviews

            Matthew J L Page, Joanne E. Mckenzie, Patrick Bossuyt … (2021)
            The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, published in 2009, was designed to help systematic reviewers transparently report why the review was done, what the authors did, and what they found. Over the past decade, advances in systematic review methodology and terminology have necessitated an update to the guideline. The PRISMA 2020 statement replaces the 2009 statement and includes new reporting guidance that reflects advances in methods to identify, select, appraise, and synthesise studies. The structure and presentation of the items have been modified to facilitate implementation. In this article, we present the PRISMA 2020 27-item checklist, an expanded checklist that details reporting recommendations for each item, the PRISMA 2020 abstract checklist, and the revised flow diagrams for original and updated reviews.
            Article 0 comments Cited 1437 times – based on 0 reviews     Review now
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              Osteoarthritis

              David Hunter, Sita M.A. Bierma-Zeinstra (2019)
              Osteoarthritis is a leading cause of disability and source of societal cost in older adults. With an ageing and increasingly obese population, this syndrome is becoming even more prevalent than in previous decades. In recent years, we have gained important insights into the cause and pathogenesis of pain in osteoarthritis. The diagnosis of osteoarthritis is clinically based despite the widespread overuse of imaging methods. Management should be tailored to the presenting individual and focus on core treatments, including self-management and education, exercise, and weight loss as relevant. Surgery should be reserved for those that have not responded appropriately to less invasive methods. Prevention and disease modification are areas being targeted by various research endeavours, which have indicated great potential thus far. This narrative Seminar provides an update on the pathogenesis, diagnosis, management, and future research on osteoarthritis for a clinical audience.
              Article 0 comments Cited 1138 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Hui Zhang
                Junqing Wang
                Zekun Jiang
                Tao Deng
                Kang Li
                Journal
                Journal ID (nlm-ta): Medicine (Baltimore)
                Journal ID (iso-abbrev): Medicine (Baltimore)
                Journal ID (publisher-id): MD
                Title: Medicine
                Publisher: Lippincott Williams & Wilkins (Hagerstown, MD )
                ISSN (Print): 0025-7974
                ISSN (Electronic): 1536-5964
                Publication date Collection: 22 December 2023
                Publication date (Electronic): 22 December 2023
                Volume: 102
                Issue: 51
                Electronic Location Identifier: e36764
                Affiliations
                [a ] Department of Orthopedics, Orthopedic Research Institute and National Clinical Research Center for Geriatrics, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan Province, China
                [b ] West China Biomedical Big Data Center, Sichuan University West China Hospital, Chengdu, Sichuan Province, China
                [c ] School of Mechanical Engineering, Sichuan University, Chengdu, Sichuan Province, China.
                Author notes
                [* ] Correspondence: Yong Nie, Department of Orthopedics, Orthopedic Research Institute and National Clinical Research Center for Geriatrics, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan Province, China (e-mail: nieyong1983@ 123456wchscu.cn ).
                Author information
                https://orcid.org/0009-0005-7813-3764
                Article
                Accession ID: 00013
                DOI: 10.1097/MD.0000000000036764
                PMC ID: 10735162
                PubMed ID: 38134064
                SO-VID: 6890c98c-8c4b-499b-aa7d-d24caae159b7
                Copyright © Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal.

                History
                Date received : 19 June 2023
                Date received : 24 November 2023
                Date accepted : 01 December 2023
                Categories
                Subject: 7000
                Subject: Research Article
                Subject: Systematic Review and Meta-Analysis
                Custom metadata
                OPEN-ACCESS TRUE
                SDC T

                Keywords: based rehabilitation,based tele,home,hospital,knee osteoarthritis,pain and function,rehabilitation
                Data availability:
                Keywords: based rehabilitation, based tele, home, hospital, knee osteoarthritis, pain and function, rehabilitation

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