PMID- 31679511
OWN - NLM
STAT- MEDLINE
DCOM- 20200327
LR  - 20231014
IS  - 1471-2474 (Electronic)
IS  - 1471-2474 (Linking)
VI  - 20
IP  - 1
DP  - 2019 Nov 3
TI  - Technology-assisted rehabilitation following total knee or hip replacement for 
      people with osteoarthritis: a systematic review and meta-analysis.
PG  - 506
LID - 10.1186/s12891-019-2900-x [doi]
LID - 506
AB  - BACKGROUND: To evaluate the effectiveness and safety of technology-assisted 
      rehabilitation following total hip/knee replacement (THR/TKR). METHODS: Six 
      electronic databases were searched without language or time restrictions for 
      relevant studies: MEDLINE, EMBASE, Cochrane Library, CINAHL, SPORTDiscus, 
      Physiotherapy Evidence Database (PEDro); from inception to November 7th, 2018. 
      Two reviewers independently applied inclusion criteria to select eligible 
      randomised controlled trials (RCTs) that investigated the effectiveness of 
      technology-based interventions, compared with usual care or no intervention for 
      people undergoing THR/TKR. Two reviewers independently extracted trial details 
      (e.g. patients' profile, intervention, outcomes, attrition and adverse events). 
      Study methodological quality was assessed using the PEDro scale. Quality of 
      evidence was critically appraised using the Grading of Recommendations, 
      Assessment, Development and Evaluation approach. RESULTS: We identified 21 
      eligible studies assessing telerehabilitation, game- or web-based therapy. There 
      were 17 studies (N = 2188) in post-TKR rehabilitation and 4 studies (N = 783) in 
      post-THR rehabilitation. Compared to usual care, technology-based intervention 
      was more effective in reducing pain (mean difference (MD): - 0.25; 95% confidence 
      interval (CI): - 0.48, - 0.02; moderate evidence) and improving function measured 
      with the timed up-and-go test (MD: -7.03; 95% CI: - 11.18, - 2.88) in people 
      undergoing TKR. No between-group differences were observed in rates of hospital 
      readmissions or treatment-related adverse events (AEs) in those studies. 
      CONCLUSION: There is moderate-quality of evidence showed technology-assisted 
      rehabilitation, in particular, telerehabilitation, results in a statistically 
      significant improvement in pain; and low-quality of evidence for the improvement 
      in functional mobility in people undergoing TKR. The effects were however too 
      small to be clinically significant. For THR, there is very limited low-quality 
      evidence shows no significant effects.
FAU - Wang, Xia
AU  - Wang X
AUID- ORCID: 0000-0003-3172-9390
AD  - Level 10 Kolling Institute, Institute of Bone and Joint Research, Royal North 
      Shore Hospital, University of Sydney, Reserve Road, St. Leonards, Sydney, NSW, 
      2065, Australia. xia.wang@sydney.edu.au.
FAU - Hunter, David J
AU  - Hunter DJ
AD  - Level 10 Kolling Institute, Institute of Bone and Joint Research, Royal North 
      Shore Hospital, University of Sydney, Reserve Road, St. Leonards, Sydney, NSW, 
      2065, Australia.
AD  - Department of Gynaecology and Obstetrics, Botucatu Medical School, San Paulo 
      State University, Sao Paulo, Brazil.
FAU - Vesentini, Giovana
AU  - Vesentini G
AD  - Level 10 Kolling Institute, Institute of Bone and Joint Research, Royal North 
      Shore Hospital, University of Sydney, Reserve Road, St. Leonards, Sydney, NSW, 
      2065, Australia.
AD  - Department of Gynaecology and Obstetrics, Botucatu Medical School, San Paulo 
      State University, Sao Paulo, Brazil.
FAU - Pozzobon, Daniel
AU  - Pozzobon D
AD  - Level 10 Kolling Institute, Institute of Bone and Joint Research, Royal North 
      Shore Hospital, University of Sydney, Reserve Road, St. Leonards, Sydney, NSW, 
      2065, Australia.
FAU - Ferreira, Manuela L
AU  - Ferreira ML
AD  - Level 10 Kolling Institute, Institute of Bone and Joint Research, Royal North 
      Shore Hospital, University of Sydney, Reserve Road, St. Leonards, Sydney, NSW, 
      2065, Australia.
LA  - eng
GR  - na/Ramsay Research Foundation/
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20191103
PL  - England
TA  - BMC Musculoskelet Disord
JT  - BMC musculoskeletal disorders
JID - 100968565
SB  - IM
MH  - Arthroplasty, Replacement, Hip/adverse effects/*trends
MH  - Arthroplasty, Replacement, Knee/adverse effects/*trends
MH  - Humans
MH  - Osteoarthritis, Hip/*rehabilitation/surgery
MH  - Osteoarthritis, Knee/*rehabilitation/surgery
MH  - Randomized Controlled Trials as Topic/methods
MH  - Telerehabilitation/*methods/trends
MH  - Walk Test/methods/trends
PMC - PMC6825714
OTO - NOTNLM
OT  - Digital health
OT  - Healthcare delivery
OT  - Joint arthroplasty
OT  - Telerehabilitation
OT  - Virtual reality
COIS- Professor Hunter provides consulting advice for Pfizer, Lilly, TLC bio and Merck 
      Serono. Associate Professor Manuela L. Ferreira is a member of the editorial 
      board of this journal. All other authors have no competing interests.
EDAT- 2019/11/05 06:00
MHDA- 2020/03/28 06:00
PMCR- 2019/11/03
CRDT- 2019/11/05 06:00
PHST- 2019/05/20 00:00 [received]
PHST- 2019/10/16 00:00 [accepted]
PHST- 2019/11/05 06:00 [entrez]
PHST- 2019/11/05 06:00 [pubmed]
PHST- 2020/03/28 06:00 [medline]
PHST- 2019/11/03 00:00 [pmc-release]
AID - 10.1186/s12891-019-2900-x [pii]
AID - 2900 [pii]
AID - 10.1186/s12891-019-2900-x [doi]
PST - epublish
SO  - BMC Musculoskelet Disord. 2019 Nov 3;20(1):506. doi: 10.1186/s12891-019-2900-x.