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The efficacy and safety of telerehabilitation for patients following total knee arthroplasty: a overviews of systematic reviews

BACKGROUND: Studies evaluating the effectiveness and safety of telerehabilitation in patients undergoing total knee arthroplasty (TKA) have increased. However, the study quality and results differ, systematic reviews are limited. We aimed to synthesise systematic reviews and meta-analyses to assess...

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Autores principales: Pang, Danli, Sun, Aiping, Wang, Fei, Lu, Jingyu, Guo, Yaorui, Ding, Wen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10560426/
https://www.ncbi.nlm.nih.gov/pubmed/37807054
http://dx.doi.org/10.1186/s12938-023-01158-z
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author Pang, Danli
Sun, Aiping
Wang, Fei
Lu, Jingyu
Guo, Yaorui
Ding, Wen
author_facet Pang, Danli
Sun, Aiping
Wang, Fei
Lu, Jingyu
Guo, Yaorui
Ding, Wen
author_sort Pang, Danli
collection PubMed
description BACKGROUND: Studies evaluating the effectiveness and safety of telerehabilitation in patients undergoing total knee arthroplasty (TKA) have increased. However, the study quality and results differ, systematic reviews are limited. We aimed to synthesise systematic reviews and meta-analyses to assess the effects of telerehabilitation in patients post-TKA. MATERIALS AND METHODS: Systematic reviews and meta-analyses regarding the effectiveness and safety of TKA telerehabilitation were retrieved from eight databases from establishment to 18 December 2022. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2), Risk of Bias in Systematic Reviews (ROBIS) and GRADE system were used to evaluate results, methods, bias and evidence quality. RESULTS: Thirteen systematic reviews and meta-analyses were analysed. The AMSTAR 2 showed low methodological quality in seven studies and very low quality in six. Among the key items, item 2 had been registered on website before systematic review in four reviews. Concerning item 4, did not provide a comprehensive search strategy in 4 reviews. For item 7, none of the reviews provided a list of reasons for excluding an article. For item 9, regarding whether appropriate tools were used to assess the risk of bias of each included study, one review was assessed as ‘partially yes’, one review only included RCTs, and the remainder were assessed as ‘yes’. For item 11, one review did not specify the statistical methods used, and three reviews did not conduct a meta-analysis. For item 13, four reviews considered the risk of bias when interpreting or discussing the study results. For item 15, seven reviews did not evaluate publication bias. The PRISMA scores of the 13 reviews ranged from 17.5 to 26.0. The PRISMA indicated that 69.2% had no protocol registration, 38.5% did not provide other materials and evidence certainty, 23.1% did not provide certainty assessment, 30.8% did not report study bias. According to the ROBIS scale, diferrent domains have diferrent risks in all the reviews. CONCLUSION: Telerehabilitation positively affects walking ability, knee extension and patient costs post-TKA surgery. Regarding the quality of life, patient satisfaction and the WOMAC, telerehabilitation had similar effects to conventional rehabilitation. Owing to the low quality of the studies, these conclusions should be interpreted cautiously, high-quality studies are needed in the future. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12938-023-01158-z.
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spelling pubmed-105604262023-10-09 The efficacy and safety of telerehabilitation for patients following total knee arthroplasty: a overviews of systematic reviews Pang, Danli Sun, Aiping Wang, Fei Lu, Jingyu Guo, Yaorui Ding, Wen Biomed Eng Online Research BACKGROUND: Studies evaluating the effectiveness and safety of telerehabilitation in patients undergoing total knee arthroplasty (TKA) have increased. However, the study quality and results differ, systematic reviews are limited. We aimed to synthesise systematic reviews and meta-analyses to assess the effects of telerehabilitation in patients post-TKA. MATERIALS AND METHODS: Systematic reviews and meta-analyses regarding the effectiveness and safety of TKA telerehabilitation were retrieved from eight databases from establishment to 18 December 2022. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2), Risk of Bias in Systematic Reviews (ROBIS) and GRADE system were used to evaluate results, methods, bias and evidence quality. RESULTS: Thirteen systematic reviews and meta-analyses were analysed. The AMSTAR 2 showed low methodological quality in seven studies and very low quality in six. Among the key items, item 2 had been registered on website before systematic review in four reviews. Concerning item 4, did not provide a comprehensive search strategy in 4 reviews. For item 7, none of the reviews provided a list of reasons for excluding an article. For item 9, regarding whether appropriate tools were used to assess the risk of bias of each included study, one review was assessed as ‘partially yes’, one review only included RCTs, and the remainder were assessed as ‘yes’. For item 11, one review did not specify the statistical methods used, and three reviews did not conduct a meta-analysis. For item 13, four reviews considered the risk of bias when interpreting or discussing the study results. For item 15, seven reviews did not evaluate publication bias. The PRISMA scores of the 13 reviews ranged from 17.5 to 26.0. The PRISMA indicated that 69.2% had no protocol registration, 38.5% did not provide other materials and evidence certainty, 23.1% did not provide certainty assessment, 30.8% did not report study bias. According to the ROBIS scale, diferrent domains have diferrent risks in all the reviews. CONCLUSION: Telerehabilitation positively affects walking ability, knee extension and patient costs post-TKA surgery. Regarding the quality of life, patient satisfaction and the WOMAC, telerehabilitation had similar effects to conventional rehabilitation. Owing to the low quality of the studies, these conclusions should be interpreted cautiously, high-quality studies are needed in the future. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12938-023-01158-z. BioMed Central 2023-10-08 /pmc/articles/PMC10560426/ /pubmed/37807054 http://dx.doi.org/10.1186/s12938-023-01158-z Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Pang, Danli
Sun, Aiping
Wang, Fei
Lu, Jingyu
Guo, Yaorui
Ding, Wen
The efficacy and safety of telerehabilitation for patients following total knee arthroplasty: a overviews of systematic reviews
title The efficacy and safety of telerehabilitation for patients following total knee arthroplasty: a overviews of systematic reviews
title_full The efficacy and safety of telerehabilitation for patients following total knee arthroplasty: a overviews of systematic reviews
title_fullStr The efficacy and safety of telerehabilitation for patients following total knee arthroplasty: a overviews of systematic reviews
title_full_unstemmed The efficacy and safety of telerehabilitation for patients following total knee arthroplasty: a overviews of systematic reviews
title_short The efficacy and safety of telerehabilitation for patients following total knee arthroplasty: a overviews of systematic reviews
title_sort efficacy and safety of telerehabilitation for patients following total knee arthroplasty: a overviews of systematic reviews
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10560426/
https://www.ncbi.nlm.nih.gov/pubmed/37807054
http://dx.doi.org/10.1186/s12938-023-01158-z
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