Effectiveness of physiotherapist-led tele-rehabilitation for older adults with chronic conditions: a systematic review and meta-analysis

Older adults live with chronic conditions worldwide. The aim of this systematic review was to determine the effectiveness of physiotherapist-led (PT-led) tele-rehabilitation on various health outcomes. Six databases were searched. Eligible studies were randomized controlled trials that included older adults (≥65 years) who had ≥1 chronic condition, and evaluated tele-rehabilitation (e.g., video, telephone) that was PT-led or overseen. Screening and data extraction were performed in duplicate. Meta-analyses were performed where appropriate. Cochrane’s Risk of Bias 2.0 tool was used. Fifteen studies were included. A meta-analysis of studies of knee osteoarthritis demonstrated that tele-rehabilitation is more effective than usual care for functional mobility (MD= −2.72, 95% CI= −3.56, −1.88, <i>p</i> &lt; 0.001), quadriceps strength (MD= 15.54, 95% CI= 10.14, 20.95, <i>p</i> &lt; 0.001), pain (MD= −1.2, 95% CI= −2.09, −0.39, <i>p</i> = 0.004) and physical function (MD= −5.95, 95% CI= −8.32, −3.58, <i>p</i> &lt; 0.001). No clear differences were found between tele-rehabilitation and usual care or comparator interventions for outcomes related to physical activity level, gait speed, mental health, and quality of life. PT-led tele-rehabilitation appears to be comparable to traditional methods at improving outcomes in older adults with various chronic conditions. However, high-quality trials are needed so future conclusions on the effectiveness of tele-rehabilitation can be made. CRD42023428048 Physiotherapist-led tele-rehabilitation appears to be more effective than usual care related to functional mobility, quadriceps strength, self-reported pain and physical function for older adults living with knee osteoarthritis.No other significant differences were found indicating that either tele-rehabilitation or traditional methods of rehabilitation can be used by clinicians to improve health outcomes for older adults living with various chronic conditions.Clinicians should familiarize themselves with the available modes, user operations, and advantages of tele-rehabilitation so that tele-rehabilitation can be better incorporated into clinical practice. Physiotherapist-led tele-rehabilitation appears to be more effective than usual care related to functional mobility, quadriceps strength, self-reported pain and physical function for older adults living with knee osteoarthritis. No other significant differences were found indicating that either tele-rehabilitation or traditional methods of rehabilitation can be used by clinicians to improve health outcomes for older adults living with various chronic conditions. Clinicians should familiarize themselves with the available modes, user operations, and advantages of tele-rehabilitation so that tele-rehabilitation can be better incorporated into clinical practice.