There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.
Abstract
Introduction Increased physical activity and functional ability are the goals of total
knee replacement surgery. Therefore, adequate rehabilitation is required for the recovery
of patients after discharge from hospital following total knee arthroplasty (TKA).
This systematic literature review aimed to evaluate the effectiveness of home telerehabilitation
in patients who underwent TKA. Methods Studies published in the English language between
2000 and 2014 were retrieved from Embase, PubMed, and Cochrane databases using relevant
search strategies. Two researchers independently reviewed the studies as per the Cochrane
methodology for systematic literature review. We considered telerehabilitation sessions
as those that were conducted by experienced physiotherapists, using videoconferencing
to patients' homes via an internet connection. The outcomes assessed included: knee
movement (knee extension and flexion); quadriceps muscle strength; functional assessment
(the timed up-and-go test); and assessment of pain, stiffness, and functional capacity
using the Western Ontario and McMaster Universities Osteoarthritis Index and visual
analogue scale for pain. Results In total, 160 potentially relevant studies were screened.
Following the screening of studies as abstracts and full-text publications, six primary
publications (four randomized controlled trials, one non-randomized controlled trial,
and one single-arm trial) were included in the review. Patients experienced high levels
of satisfaction with the use of telerehabilitation alone. There was no significant
difference in change in active knee extension and flexion in the home telerehabilitation
group as compared to the control group (mean difference (MD) -0.52, 95% CI -1.39 to
0.35, p = 0.24 and MD 1.14, 95% CI -0.61 to 2.89, p = 0.20, respectively). The patients
in the home telerehabilitation group showed improvement in physical activity and functional
status similar to patients in the conventional therapy group. Discussion The evidence
from this systematic literature review demonstrated that telerehabilitation is a practical
alternative to conventional face-to-face rehabilitation therapy in patients who underwent
TKA.