The comparison of telerehabilitation and face-to-face rehabilitation after total knee arthroplasty: A systematic review and meta-analysis

Abstract

Introduction

The objective of this study was to assess the efficacy of telerehabilitation for patients after total knee arthroplasty (TKA) compared with face-to-face rehabilitation.

Methods

Medline, SCOPUS, Google Scholar, EMBASE, Springer, Science Direct, and Cochrane databases were searched electronically. Relevant journals and references of studies included were hand-searched for randomized controlled trials (RCTs) regarding the efficacy of telerehabilitation on functional recovery in patients after TKA. Two reviewers independently performed data extraction and quality assessment. Data were analysed using RevMan 5.3 software and Stata 12.0 software.

Results

Four RCTs involving 442 patients were included in the meta-analysis. Overall, compared with face-to-face rehabilitation, telerehabilitation could achieve comparable pain relief (mean difference = 0.52; 95% confidence interval (CI) = −0.20 to 1.24; p = 0.16) and better Western Ontario and McMaster Universities Osteoarthritis Index improvement (mean difference = 1.13; 95% CI = 0.23 to 2.02; p = 0.014). In addition, telerehabilitation treatment resulted in a significantly higher extension range (p < 0.00001) and quadriceps strength (p = 0.0002) than face-to-face rehabilitation.

Discussion

Telerehabilitation should be recommended for patients after TKA because of its comparable pain control and better improvement of functional recovery as compared to face-to-face rehabilitation.

Keywords

Telerehabilitation face-to-face rehabilitation total knee arthroplasty (TKA)functional recovery meta-analysis

Get full access to this article

View all access options for this article.

References

Tian

DeJong

Brown

et al.

Looking upstream: factors shaping the demand for postacute joint replacement rehabilitation. Arch Phys Med Rehab 2009; 90: 1260–1268.

Vide

Freitas

Ramos

et al.

Patient-specific instrumentation in total knee arthroplasty: simpler, faster and more accurate than standard instrumentation—a randomized controlled trial. Knee Surg Sport Tr A 2015. DOI: 10.1007/s00167-015-3869-0.

Conditt

Gustke

Coon

et al.

Intra-operative safety and early patient recovery in robotic arm assisted total knee arthroplasty. Bone Joint J 2016; 98: 49–49.

Liu

Kaneko

Kurosawa

et al.

Postoperative mechanical alignment of the lower limb corresponding to the successful clinical outcome after total knee arthroplasty (TKA). Osteoarthr Cartilage 2015; 23: A409–A409.

Dahabreh

Scholes

Giuffre

et al.

Lack of agreement between computer navigation and post-operative 2-dimensional computed tomography (CT) measurements for component and limb alignment in total knee arthroplasty (TKA). Knee 2015; 23: 137–143.

Patterson

Bland

Thomas

et al.

The adductor canal block provides effective analgesia similar to a femoral nerve block in patients undergoing total knee arthroplasty— a retrospective study. J Clin Anesth 2015; 27: 39–44.

Roos

. Effectiveness and practice variation of rehabilitation after joint replacement. Curr Opin Rheumatol 2003; 15: 160–162.

Walsh

Herbold

. Outcome after rehabilitation for total joint replacement at IRF and SNF: a case-controlled comparison. Am J Phys Med Rehabil 2006; 85: 1–5.

Moffet

Collet

J-P

Shapiro

et al.

Effectiveness of intensive rehabilitation on functional ability and quality of life after first total knee arthroplasty: a single-blind randomized controlled trial. Arch Phys Med Rehabil 2004; 85: 546–556.

10.

Naylor

Harmer

Fransen

et al.

Status of physiotherapy rehabilitation after total knee replacement in Australia. Physiother Res Int 2006; 11: 35–47.

11.

Calatayud

Jakobsen

Sundstrup

et al.

Dose-response association between leisure time physical activity and work ability: cross-sectional study among 3000 workers. Scand J Public Health 2015; 43: 819–824.

12.

Leijten

van den Heuvel

van der Beek

et al.

Associations of work-related factors and work engagement with mental and physical health: a 1-year follow-up study among older workers. J Occup Rehabil 2015; 25: 86–95.

13.

Novak

Beyeler

Omlin

et al.

Workload estimation in physical human–robot interaction using physiological measurements. Interact Comput 2015; 27: 616–629.

14.

Russell

. Telerehabilitation: a coming of age. Aust J Physiother 2009; 55: 5–6.

15.

Tousignant

Moffet

Boissy

et al.

A randomized controlled trial of home telerehabilitation for post-knee arthroplasty. J Telemed Telecare 2011; 17: 195–198.

16.

Bini

Mahajan

. Clinical outcomes of remote asynchronous telerehabilitation are equivalent to traditional therapy following total knee arthroplasty: a randomized control study. J Telemed Telecare 2016. DOI: 10.1177/1357633X16634518.

17.

Moffet

Tousignant

Nadeau

et al.

In-home telerehabilitation compared with face-to-face rehabilitation after total knee arthroplasty. J Bone Joint Surg Am 2015; 97: 1129–1141.

18.

Piqueras

Marco

Coll

et al.

Effectiveness of an interactive virtual telerehabilitation system in patients after total knee arthoplasty: a randomized controlled trial. J Rehabil Med 2013; 45: 392–396.

19.

Russell

Buttrum

Wootton

et al.

Internet-based outpatient telerehabilitation for patients following total knee arthroplasty. J Bone Joint Surg Am 2011; 93: 113–120.

20.

Tousignant

Boissy

Corriveau

et al.

In-home telerehabilitation for post-knee arthroplasty: a pilot study. Inter J Telerehabil 2009; 1: 9–16.

21.

Moher

Liberati

Tetzlaff

et al.

Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 2009; 339: b2535–b2535.

22.

Higgins JPT and Green S. Cochrane handbook for systematic reviews of interventions, version 5.1.0. The Cochrane Collaboration, http://handbook.cochrane.org (2011)

23.

Jadad

Moore

Carroll

et al.

Assessing the quality of reports of randomized clinical trials: is blinding necessary?

Control Clin Trials 1996; 17: 1–12.

24.

Kjaergard

Villumsen

Gluud

. Reported methodologic quality and discrepancies between large and small randomized trials in meta-analyses. Ann Intern Med 2001; 135: 982–989.

25.

Shukla

Nair

Thakker

. Role of telerehabilitation in patients following total knee arthroplasty: evidence from a systematic literature review and meta-analysis. J Telemed Telecare 2016. DOI: 10.1177/1357633X16628996.

26.

Kramer

Speechley

Bourne

et al.

Comparison of clinic- and home-based rehabilitation programs after total knee arthroplasty. Clin Orthop Relat Res 2003; 410: 225–234.

27.

Westby

Brittain

Backman

. Expert consensus on best practices for post-acute rehabilitation after total hip and knee arthroplasty: a Canada and United States Delphi study. Arthritis Care Res 2014; 66: 411–423.

28.

Tousignant

Moffet

Nadeau

et al.

Cost analysis of in-home telerehabilitation for post-knee arthroplasty. J Med Internet Res 2015; 17: e83–e83.