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, p < 0.001), quadriceps strength (MD= 15.54, 95% CI= 10.14, 20.95, p < 0.001), pain (MD= −1.2, 95% CI= −2.09, −0.39, p = 0.004) and physical function (MD= −5.95, 95% CI= −8.32, −3.58, p < 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.

全球范围内，老年群体普遍罹患慢性疾病。本系统综述旨在探讨由物理治疗师主导（physiotherapist-led，以下简称PT-led）的远程康复（tele-rehabilitation）对各类健康结局的干预效果。
本研究检索了6个数据库。纳入的研究为针对≥65岁老年群体的随机对照试验，受试对象需罹患至少1种慢性疾病，且研究评估由PT-led主导或监督开展的远程康复干预（如视频、电话形式）。筛选流程与数据提取均采用双人重复核对。在适宜情况下开展荟萃分析，并使用Cochrane偏倚风险2.0工具进行研究质量评价。
本研究共纳入15项符合标准的研究。针对膝骨关节炎相关研究的荟萃分析结果显示，相较于常规照护，远程康复在功能活动能力（均差MD=-2.72，95%置信区间CI=-3.56~-1.88，p<0.001）、股四头肌肌力（MD=15.54，95%CI=10.14~20.95，p<0.001）、自评疼痛程度（MD=-1.2，95%CI=-2.09~-0.39，p=0.004）以及躯体功能（MD=-5.95，95%CI=-8.32~-3.58，p<0.001）方面均表现更优。而在身体活动水平、步速、心理健康与生活质量相关结局中，远程康复与常规照护或对照干预方案未表现出显著差异。
PT-led远程康复在改善各类慢性疾病老年群体健康结局方面，与传统康复手段效果相当。但仍需开展高质量研究，以便未来可就远程康复的干预效果得出更确凿的结论。
CRD42023428048

针对膝骨关节炎老年群体，PT-led远程康复在功能活动能力、股四头肌肌力、自评疼痛及躯体功能方面，均优于常规照护。
未发现其他显著差异，提示临床医师可采用远程康复或传统康复手段，改善各类慢性疾病老年群体的健康结局。
临床医师应熟悉远程康复的现有模式、操作流程与优势，以便更好地将其融入临床实践。

针对膝骨关节炎老年群体，PT-led远程康复在功能活动能力、股四头肌肌力、自评疼痛及躯体功能方面，均优于常规照护。
未发现其他显著差异，提示临床医师可采用远程康复或传统康复手段，改善各类慢性疾病老年群体的健康结局。
临床医师应熟悉远程康复的现有模式、操作流程与优势，以便更好地将其融入临床实践。