The efficacy of home-based remote rehabilitation versus usual rehabilitation for patients with knee osteoarthritis: A systematic review and meta-analysis.
Eric Pasqualotto, Rafael Oliva Morgado Ferreira, Leonardo Salvatore Migliardi, Pedro Henrique Felisbino Silva, Tales Pasqualotto, Joyce Cristina Campos, Julia de Lira Kaszubowski, Sabrina da Silva, Serafim Barros, Luis Fernando Z Funchal
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引用次数: 0
Abstract
Purpose: To compare home-based remote rehabilitation with usual rehabilitation care for knee osteoarthritis (OA).
Methods: PubMed, Cochrane, and Embase databases were searched for randomized controlled trials (RCTs) comparing home-based remote rehabilitation (telephone calls, video calls, apps, or websites) with usual in-person rehabilitation in patients with knee OA. Mean differences (MDs) or standardized mean differences (SMDs) were calculated for continuous outcomes and risk ratios (RRs) for binary outcomes, with 95 % confidence intervals (CIs). Statistical analyses were performed using R Software, version 4.4.1.
Results: A total of 9 RCTs were included, comprising 974 patients with knee OA, of whom 483 (49.6 %) were randomized to home-based remote rehabilitation. Compared with usual rehabilitation, home-based remote rehabilitation significantly reduced pain severity (SMD -0.34; 95 % CI -0.67 to -0.02) and significantly improved physical activity levels (SMD -0.45; 95 % CI -0.85 to -0.05). Furthermore, the home-based remote rehabilitation group showed a significant reduction in pain assessed with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) (MD -0.95 points; 95 % CI -1.84 to -0.06), an improvement in functionality assessed with the Timed Up and Go test (MD -0.83 s; 95 % CI -1.64 to -0.02), and a greater patient satisfaction (RR 2.01; 95 % CI 1.46 to 2.76).
Conclusion: The results demonstrated that home-based remote rehabilitation reduced pain and increased patient satisfaction, however, there is insufficient evidence to state that remote rehabilitation significantly improved physical activity and functionality. Home-based remote rehabilitation appears to be a viable and effective alternative for patients with knee OA.
目的：比较家庭远程康复与常规康复治疗对膝骨关节炎（OA）的影响。方法：检索PubMed、Cochrane和Embase数据库，比较基于家庭的远程康复（电话、视频通话、应用程序或网站）与膝关节OA患者通常的面对面康复的随机对照试验（rct）。计算连续结局的平均差异（md）或标准化平均差异（SMDs），以及二元结局的风险比（rr），置信区间为95% （ci）。采用R软件4.4.1版本进行统计分析。结果：共纳入9项随机对照试验，共纳入974例膝关节OA患者，其中483例（49.6%）随机接受家庭远程康复治疗。与常规康复相比，居家远程康复显著降低疼痛严重程度(SMD -0.34；95% CI -0.67至-0.02)和显著改善的身体活动水平(SMD -0.45；95% CI -0.85 ~ -0.05)。此外，根据西安大略省和麦克马斯特大学骨关节炎指数（WOMAC）评估，以家庭为基础的远程康复组疼痛显著减轻(MD -0.95分；95% CI -1.84至-0.06)，通过Timed Up and Go测试评估的功能改善(MD -0.83 s；95% CI -1.64 ~ -0.02)，患者满意度更高(RR 2.01；95% CI 1.46 - 2.76)。结论：结果表明，以家庭为基础的远程康复减轻了疼痛，提高了患者满意度，然而，没有足够的证据表明远程康复显著改善了身体活动和功能。以家庭为基础的远程康复似乎是一个可行的和有效的替代膝关节OA患者。
期刊介绍：
The Journal of Orthopaedic Science is the official peer-reviewed journal of the Japanese Orthopaedic Association. The journal publishes the latest researches and topical debates in all fields of clinical and experimental orthopaedics, including musculoskeletal medicine, sports medicine, locomotive syndrome, trauma, paediatrics, oncology and biomaterials, as well as basic researches.
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