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Published on: May 16, 2025
Effectiveness of real-time visual supervised telerehabilitation on functioning following knee arthroplasty compared
Alessandro de Sire1,2, Emanuele Prestifilippo1, Erminia Cofano3
1Physical Medicine and Rehabilitation, Department of Medical and Surgical Sciences University of Catanzaro 'Magna Graecia' Catanzaro Italy.
Purpose:
With advances in digital healthcare technologies, telerehabilitation has recently been utilized to deliver rehabilitation in real time following orthopaedic surgery; in this scenario, therapeutic exercise, robotic rehabilitation and virtual reality approaches might be tailored to the patient's needs by professionals, utilizing digital smart devices, in a videoconferencing-based approach with a positive impact on the patients. There remains a relative paucity of high-quality research evaluating the effectiveness of real-time visual-supervised telerehabilitation (RTVST) compared to outpatient rehabilitation following total knee arthroplasty (TKA) in the current literature. This systematic review of randomized controlled trials (RCTs) aimed to assess the clinical efficacy of RTVST after TKA in terms of outcomes and knee function using the Western Ontario and McMaster Universities Arthritis Index (WOMAC) compared with outpatient or home-based exercise.
Methods:
PubMed, Scopus and Web of Science databases were systematically searched for English-language RCTs published from 2015 to 2025. Of 577 studies identified, five RCTs were included after screening according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
Results:
The included studies, conducted across various countries and utilizing diverse telerehabilitation models (e.g., videoconferencing and wearable sensors), consistently suggest that RTVST is a feasible, safe and often noninferior alternative to traditional rehabilitation, with some studies indicating superior or faster functional recovery in specific parameters. RTVST also offered potential benefits in cost-effectiveness. However, limitations such as technological barriers for the elderly and an overall high risk of bias in the included studies were noted.
Conclusions:
This systematic review demonstrated that RTVST provides comparable functional outcomes and patient-reported improvements to conventional rehabilitation but highlighted the urgent need for further high-quality research with larger sample sizes and standardized telerehabilitation protocols to clarify its precise role and optimize technological applications.
Level Of Evidence:
N/A.
