{"title":"Efficacy of telerehabilitation for total knee arthroplasty: a meta-analysis based on randomized controlled trials combined with a bibliometric study.","authors":"Xu Liu, Guang Yang, Wenqing Xie, Wenhao Lu, Gaoming Liu, Wenfeng Xiao, Yusheng Li","doi":"10.1186/s13018-024-05381-9","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Physical therapy (PT) is widely employed in osteoarthritis (OA). This study aimed to explore the research development of PT for OA and to identify the emerging treatment, and verify its efficacy.</p><p><strong>Materials and methods: </strong>The Web of Science Core Collection was used to conduct the bibliometric analysis. Furthermore, a meta-analysis based on randomized controlled trials (RCTs) was performed to evaluate the identified treatment's efficacy.</p><p><strong>Results: </strong>A total of 3,142 articles were retrieved from the Web of Science Core Collection, and the annual publication volume shows an exponential growth trend (R<sup>2</sup> = 0.9515). Keyword analysis demonstrated that telerehabilitation (TELE) in total knee arthroplasty (TKA) has become a hotspot since 2020. To assess the effectiveness of TELE, we conducted a meta-analysis of 25 RCTs including 4402 patients. In the total analysis, the TELE group exhibited superior outcomes compared to the traditional face-to-face (FTF) rehabilitation group in terms of pain (standardized mean differences [SMD]: - 0.15, 95% CI - 0.27 to - 0.04, P = 0.01), passive flexion (MD: 2.60, 95% CI 0.77 to 4.44, P = 0.005), quadriceps muscle strength (SMD: 0.32, 95% CI 0.04 to 0.61, P = 0.03), and cost (SMD: - 0.50, 95% CI - 0.88 to - 0.12, P = 0.009). The subgroup analysis also demonstrated that the fixed equipment-assisted telerehabilitation (FEAT) group and the mobile device-assisted telerehabilitation (MDAT) group were superior to the FTF group. Moreover, patients in the FEAT group exhibited better prognoses than those in the MDAT group. No significant differences in the other measured outcome were observed.</p><p><strong>Conclusion: </strong>Telerehabilitation proved to be more effective than traditional FTF rehabilitation in patients who underwent TKA. Further research is warranted to compare the different TELE interventions to establish the best protocols and timing for interventions.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"874"},"PeriodicalIF":2.8000,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670389/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Orthopaedic Surgery and Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13018-024-05381-9","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Physical therapy (PT) is widely employed in osteoarthritis (OA). This study aimed to explore the research development of PT for OA and to identify the emerging treatment, and verify its efficacy.
Materials and methods: The Web of Science Core Collection was used to conduct the bibliometric analysis. Furthermore, a meta-analysis based on randomized controlled trials (RCTs) was performed to evaluate the identified treatment's efficacy.
Results: A total of 3,142 articles were retrieved from the Web of Science Core Collection, and the annual publication volume shows an exponential growth trend (R2 = 0.9515). Keyword analysis demonstrated that telerehabilitation (TELE) in total knee arthroplasty (TKA) has become a hotspot since 2020. To assess the effectiveness of TELE, we conducted a meta-analysis of 25 RCTs including 4402 patients. In the total analysis, the TELE group exhibited superior outcomes compared to the traditional face-to-face (FTF) rehabilitation group in terms of pain (standardized mean differences [SMD]: - 0.15, 95% CI - 0.27 to - 0.04, P = 0.01), passive flexion (MD: 2.60, 95% CI 0.77 to 4.44, P = 0.005), quadriceps muscle strength (SMD: 0.32, 95% CI 0.04 to 0.61, P = 0.03), and cost (SMD: - 0.50, 95% CI - 0.88 to - 0.12, P = 0.009). The subgroup analysis also demonstrated that the fixed equipment-assisted telerehabilitation (FEAT) group and the mobile device-assisted telerehabilitation (MDAT) group were superior to the FTF group. Moreover, patients in the FEAT group exhibited better prognoses than those in the MDAT group. No significant differences in the other measured outcome were observed.
Conclusion: Telerehabilitation proved to be more effective than traditional FTF rehabilitation in patients who underwent TKA. Further research is warranted to compare the different TELE interventions to establish the best protocols and timing for interventions.
期刊介绍：
Journal of Orthopaedic Surgery and Research is an open access journal that encompasses all aspects of clinical and basic research studies related to musculoskeletal issues.
Orthopaedic research is conducted at clinical and basic science levels. With the advancement of new technologies and the increasing expectation and demand from doctors and patients, we are witnessing an enormous growth in clinical orthopaedic research, particularly in the fields of traumatology, spinal surgery, joint replacement, sports medicine, musculoskeletal tumour management, hand microsurgery, foot and ankle surgery, paediatric orthopaedic, and orthopaedic rehabilitation. The involvement of basic science ranges from molecular, cellular, structural and functional perspectives to tissue engineering, gait analysis, automation and robotic surgery. Implant and biomaterial designs are new disciplines that complement clinical applications.
JOSR encourages the publication of multidisciplinary research with collaboration amongst clinicians and scientists from different disciplines, which will be the trend in the coming decades.
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