Telerehabilitation for musculoskeletal pain – An overview of systematic reviews

BACKGROUND: Alternative measures for minimizing musculoskeletal pain, such as telerehabilitation, can be implemented in the context of the COVID-19 pandemic. OBJECTIVE: The aim of the present overview was to examine evidence from systematic reviews of telerehabilitation for managing musculoskeletal pain. METHODS: This study was conducted following the PRISMA recommendations. Searches were conducted of the Pubmed/Medline, Scopus, Cochrane Library, Web of Science and Embase databases for review articles published from the inception of the database to July 2022. To be included, the studies needed to be a systematic review, include any type of telerehabilitation and present any outcome related to musculoskeletal pain. Studies not available in English were excluded. Theses, dissertations, letters, conference abstracts and narrative reviews were also excluded. The methodological quality of the reviews was appraised using the Assessing the Methodological Quality of Systematic Reviews criteria. Data extraction was performed by two reviewers and included the characterization of the clinical condition and telerehabilitation program, main outcomes, method for appraising the methodological quality of the primary studies, results and quality of evidence. RESULTS: The search led to the retrieval of 390 potentially eligible studies and 16 systematic reviews were included in this overview. Eleven reviews had meta-analyses and most had high methodological quality. Five of six systematic reviews reported evidence supporting the telehealth intervention for chronic pain conditions; and two of three high-quality systematic reviews reported the absence of evidence for non-specific low back pain. CONCLUSIONS: This overview of systematic reviews enables a better understanding of the characteristics of telerehabilitation programs, provides information for use in clinical practice and describes gaps in the research that need to be filled.