Effectiveness of Telerehabilitation in Physical Therapy: A Rapid Overview

Author:

Seron Pamela1ORCID,Oliveros María-Jose1,Gutierrez-Arias Ruvistay2,Fuentes-Aspe Rocío1,Torres-Castro Rodrigo C3,Merino-Osorio Catalina4,Nahuelhual Paula56,Inostroza Jacqueline7,Jalil Yorschua89,Solano Ricardo10,Marzuca-Nassr Gabriel N7,Aguilera-Eguía Raul11,Lavados-Romo Pamela12,Soto-Rodríguez Francisco J1314,Sabelle Cecilia1516,Villarroel-Silva Gregory1718,Gomolán Patricio19,Huaiquilaf Sayen20,Sanchez Paulina21

Affiliation:

1. Internal Medicine Department and CIGES, Faculty of Medicine, Universidad de La Frontera, Temuco, Chile

2. Instituto Nacional del Tórax and Escuela de Kinesiología, Facultad de Ciencias de la Rehabilitación, Universidad Andres Bello, Santiago, Chile

3. Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile

4. Carrera de Kinesiología, Facultad de Medicina, Clínica Alemana- Universidad del Desarrollo, Santiago, Chile

5. Departamento de Evaluación de Tecnologías Sanitarias y Salud Basada en Evidencia, Ministerios de Salud, Santiago, Chile

6. Facultad de Medicina, Clínica Alemana de Santiago – Universidad del Desarrollo, Santiago, Chile

7. Internal Medicine Department, Faculty of Medicine, Universidad de La Frontera, Temuco, Chile

8. Escuela de Kinesiología, Facultad de Ciencias de la Rehabilitación, Universidad Andres Bello

9. Programa de Doctorado Ciencias Medicas, Pontificia Universidad Católica de Chile, Escuela de Medicina, Santiago, Chile

10. Medical Specialties Medicine Department, Faculty of Medicine, Universidad de La Frontera, Temuco, Chile

11. Departamento de Salud Pública and Carrera de Kinesiología, Facultad de Medicina, Universidad Católica de la Santísima Concepción, Concepción, Chile

12. Departamento Ciencias Preclínicas, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile

13. Internal Medicine Department, Faculty of Medicine, Universidad de La Frontera

14. Facultad de Ciencias de la Salud, Carrera de Kinesiología, Universidad Autónoma de Chile, Temuco, Chile

15. Universidad Santo Tomás, Temuco, Chile

16. Servicio de Salud Araucanía Sur, Temuco, Chile

17. Departamento Ciencias de la Salud, Carrera de Kinesiología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile

18. Hospital Josefina Martínez, Santiago, Chile

19. Escuela de Medicina, Universidad de Santiago de Chile, Santiago

20. Pediatrics and Child surgery Department, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile

21. Hospital Dr. Hernán Henríquez Aravena, Temuco, Chile

Abstract

Abstract Objective The purpose of this article was to summarize the available evidence from systematic reviews on telerehabilitation in physical therapy. Methods We searched Medline/PubMed, EMBASE, and Cochrane Library databases. In addition, the records in PROSPERO and Epistemonikos and PEDro were consulted. Systematic reviews of different conditions, populations, and contexts—where the intervention to be evaluated is telerehabilitation by physical therapy—were included. The outcomes were clinical effectiveness depending on specific condition, functionality, quality of life, satisfaction, adherence, and safety. Data extraction and risk of bias assessment were carried out by a reviewer with non-independent verification by a second reviewer. The findings are reported qualitatively in the tables and figures. Results Fifty-three systematic reviews were included, of which 17 were assessed as having low risk of bias. Fifteen reviews were on cardiorespiratory rehabilitation, 14 on musculoskeletal conditions, and 13 on neurorehabilitation. The other 11 reviews addressed other types of conditions and rehabilitation. Thirteen reviews evaluated with low risk of bias showed results in favor of telerehabilitation versus in-person rehabilitation or no rehabilitation, while 17 reported no differences between the groups. Thirty-five reviews with unclear or high risk of bias showed mixed results. Conclusions Despite the contradictory results, telerehabilitation in physical therapy could be comparable with in-person rehabilitation or better than no rehabilitation for conditions such as osteoarthritis, low-back pain, hip and knee replacement, and multiple sclerosis and also in the context of cardiac and pulmonary rehabilitation. It is imperative to conduct better quality clinical trials and systematic reviews. Impact Providing the best available evidence on the effectiveness of telerehabilitation to professionals, mainly physical therapists, will impact the decision-making process and therefore yield better clinical outcomes for patients, both in these times of the COVID-19 pandemic and in the future. The identification of research gaps will also contribute to the generation of relevant and novel research questions.

Funder

Fondecyt Program of National Agency for Research and Development

Publisher

Oxford University Press (OUP)

Subject

Physical Therapy, Sports Therapy and Rehabilitation

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