The effectiveness of internet-based telerehabilitation among patients after total joint arthroplasty: A systematic review and meta-analysis of randomised controlled trials.

INTRODUCTION: The aim of this review was to systematically evaluate the available evidence on the effectiveness of internet-based telerehabilitation among patients after total joint arthroplasty regarding pain, range of motion, physical function, health-related quality of life, satisfaction, and psychological well-being. METHODS: This was a systematic review with meta-analysis based on the Cochrane Handbook for Systematic Reviews of Interventions guidelines. Studies published in English or Chinese were searched using defined search periods, databases, and search terms. Two reviewers assessed independently the quality of studies. RevMan 5.3 was used for meta-analysis. Heterogeneity was assessed using the χ2 and I2 statistic. A random effect model and mean difference (MD) with 95% confidence interval (CI) was adopted. Standardised mean difference (SMD) was used if the outcome was measured by different scales. RESULTS: Eleven studies with 1020 participants were analysed. Compared to face-to-face rehabilitation, internet-based telerehabilitation showed no significant difference in outcomes of pain (SMD-0.11, 95% CI-0.32 to 0.10), range of motion in flexion (MD 0.65, 95% CI-1.18 to 2.48) and extension (MD-0.38, 95% CI-1.16 to 0.40), patient-reported physical function (SMD 0.01, 95% CI-0.15 to 0.17), health-related quality of life (SMD-0.09, 95% CI-0.26 to 0.07), satisfaction (SMD-0.04, 95% CI-0.21 to 0.14), and psychological well-being (SMD 0.10, 95% CI-0.13 to 0.33). Internet-based telerehabilitation showed better outcomes in physical functional tests (SMD-0.54, 95% CI-1.08 to-0.01). DISCUSSION: This review suggests that internet-based telerehabilitation has comparable effectiveness to face-to-face rehabilitation on rehabilitation outcomes among patients after total joint arthroplasty.

The lifestyle behaviours and psychosocial well-being of primary school students in Hong Kong.

AIMS: To examine the lifestyle behaviours and psychosocial well-being of primary school students in Hong Kong. BACKGROUND: The establishment of healthy lifestyle habits and maintenance of psychosocial well-being during early adolescence can prevent the morbidity and mortality caused by unhealthy practices. DESIGN: A cross-sectional study. METHODS: A questionnaire was used to solicit information on primary school students' lifestyle behaviours and psychosocial well-being using the Chinese version of the Adolescent Lifestyle Questionnaire (C-ALQ). RESULTS: Out of 249 primary school students, 241 returned their questionnaires (a response rate of 96.8%). Results on the lifestyle behaviours of students indicated that nearly half of them 'play sports at least three times a week' (n = 111, 46.1%), 'try not to eat foods high in fats/salt' (n = 112, 46.5%), 'report unusual bodily changes to nurses, parents, friends or physician' (n = 136, 56.4%) and 'avoid doing drugs' (n = 186, 77.2%). Results for the psychosocial well-being of students showed that nearly half 'use helpful strategies to deal with stress' (n = 104, 43.2%), are 'confident about [their] own beliefs and values in life' (n = 143, 59.3%) and 'enjoy spending time with friends' (n = 169, 70.1%). Male students were found less likely than females to demonstrate 'health awareness' (t = 4.87, p = 0.028) and 'social support'(t = 4.17, p = 0.042) and to have better overall psychosocial well-being (t = 5.43, p = 0.021). CONCLUSIONS: Primary school students have various health education needs related to lifestyle behavioural choices and the maintenance of psychosocial well-being. Lifestyle choices are formed in early adolescence; therefore, health education must begin as early as possible to influence healthy behaviours. RELEVANCE TO CLINICAL PRACTICE: School nurses should assess health needs across the school-age population and develop programmes to address these overall needs. School nurses are needed to cater for the needs of students, particularly boys, to establish health programmes for lifelong healthy lifestyles and psychosocial well-being and to monitor their health status.