Clinical Effect of Telerehabilitation after Total Knee Arthroplasty: a Meta-analysis / 中国康复理论与实践

ABSTRACT

Objective:To evaluate the outcome of telerehabilitation in pain control and function recovery after total knee arthroplasty. Methods:CNKI, Wanfang Data (WF), CBM, VIP, PubMed, Web of Science, Medline, Springer Link, and Cochrane Library were searched on the effects of telerehabilitation on the patients after total knee arthroplasty, and the literatures of random control trials (RCT) study in English and Chinese in the above databases from 2000 to 2018 were collected. Literature screening, quality evaluation, data extraction and data analysis were carried out by 2 researchers. The indexes of outcome in the RCT studies included Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), extension and flexion range, the Timed Up and Go Test (TUGT), Visual Analogue Scale (VAS) and Knee Injury and Osteoarthritis Outcome Score (KOOS). Results:A total of 6 RCT studies were included, with a total of 601 cases, 301 in the intervention group and 300 in the control group. There was difference in extension range (MD = 0.30, 95%CI 0.20 to 0.40, P < 0.001), TUGT scores (MD = -5.17, 95%CI -9.79 to -0.55, P = 0.03), VAS scores (MD = -0.43, 95%CI -0.85 to -0.01, P = 0.04) and KOOS scores (MD = -1.10, 95%CI -1.63 to 0.57, P < 0.0001) between two groups. There was no significant difference in WOMAC scores (MD = -0.32, 95%CI -2.30 to 1.65, P = 0.75), flexion range (MD = 0.68, 95%CI -2.28 to 3.63, P = 0.65), and muscle strength (MD = 13.77, 95%CI -3.89 to 31.43, P = 0.13) (P > 0.05) between two groups. Conclusion:Telerehabilitation is effective to improve extension range, ambulation, pain and quality of life, while it is uncertainly effective in flexion range, knee function and muscle strength.