Home-based tele-rehabilitation versus hospital-based outpatient rehabilitation for pain and function after initial total knee arthroplasty: A systematic review and meta-analysis

被引：5

作者：

Zhang, Hui ^{[1
,2
,3
]}

Wang, Junqing ^{[1
,2
]}

Jiang, Zekun ^{[3
]}

Deng, Tao ^{[4
]}

Li, Kang ^{[3
]}

Nie, Yong ^{[1
,2
]}

机构：

[1] Sichuan Univ, West China Hosp, Orthoped Res Inst, Dept Orthoped,West China Med Sch, Chengdu, Sichuan, Peoples R China

[2] Sichuan Univ, West China Hosp, Natl Clin Res Ctr Geriatr, West China Med Sch, Chengdu, Sichuan, Peoples R China

[3] Sichuan Univ, West China Hosp, West China Biomed Big Data Ctr, Chengdu, Sichuan, Peoples R China

[4] Sichuan Univ, Sch Mech Engn, Chengdu, Sichuan, Peoples R China

来源：

MEDICINE | 2023年 / 102卷 / 51期

关键词：

based rehabilitation; based tele; home; hospital; knee osteoarthritis; pain and function; rehabilitation; REPLACEMENT; PROGRAM; OSTEOARTHRITIS; KINEMATICS; EXERCISE; CARE; HIP;

D O I：

10.1097/MD.0000000000036764

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background:This systematic review and meta-analysis aims to compare the effectiveness of home-based tele-rehabilitation programs with hospital-based rehabilitation programs in improving pain and function at various time points (<= 6 weeks, <= 14 weeks, and <= 52 weeks) following the initial total knee arthroplasty.Methods:This study used PRISMA and AMSTAR reporting guidelines. We systematically searched 5 databases (PubMed, Embase, Web of Science, Cochrane Library, and Medline) to identify randomized controlled trials published from January 1, 2019, to January 1, 2023. The primary outcomes were pain, knee injury and osteoarthritis outcome score, and mobility (knee range of motion).Results:We included 9 studies involving 1944 patients. Low-quality evidence showed hospital-based rehabilitation was better than home-based tele-rehabilitation in knee injury and osteoarthritis outcome score (mean difference [MD], -2.62; 95% confidence interval [CI], -4.65 to -0.58; P = .01) at <= 14 weeks after total knee arthroplasty. Based on low-quality evidence, home-based tele-rehabilitation was better than hospital-based rehabilitation in knee range of motion (MD, 2.00; 95% CI, 0.60 to 3.40; P = .005). There was no significant difference between hospital-based rehabilitation and home-based tele-rehabilitation in knee pain at <= 6 weeks (MD, 0.18; 95% CI, -0.07 to 0.42; P = .16), 14 weeks (MD, 0.12; 95% CI, -0.26 to 0.49; P = .54), and <= 52 weeks (MD, 0.16; 95% CI, -0.11 to 0.43; P = .24).Conclusion:Home-based tele-rehabilitation and hospital-based rehabilitation programs showed comparable long-term outcomes in pain, mobility, physical function, and patient-reported health status after primary total knee arthroplasty. Considering the economic costs, home-based tele-rehabilitation programs are recommended as a viable alternative to hospital-based rehabilitation programs.

引用

页数：8

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