Advances in Digital Physiotherapy and Rehabilitation: A Systematic Review

Digital health technologies have rapidly transformed physiotherapy rehabilitation by improving accessibility, patient engagement, remote monitoring, and continuity of care. Interventions such as telerehabilitation, wearable devices, artificial intelligence (AI), virtual reality (VR), smartphone-based applications, and remote monitoring systems are increasingly being integrated into musculoskeletal, neurological, and cardiovascular rehabilitation. This systematic review aimed to evaluate the clinical effectiveness of these digital health technologies by synthesizing evidence from randomized controlled trials (RCTs). A systematic search of PubMed/MEDLINE, Scopus, Web of Science, PEDro, Cochrane Library, and Google Scholar identified English-language RCTs published between January 2021 and July 2026. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, and the methodological quality of the included studies was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool. Owing to heterogeneity in interventions, outcome measures, and study populations, findings were synthesized narratively. Fourteen RCTs involving musculoskeletal, neurological, and cardiovascular populations met the eligibility criteria. Overall, digital health interventions significantly improved pain, physical function, mobility, range of motion, exercise adherence, functional independence, and quality of life. Telerehabilitation demonstrated outcomes comparable to conventional face-to-face physiotherapy for musculoskeletal disorders, wearable technologies enhanced motor recovery and functional performance in neurological rehabilitation, and remote cardiac rehabilitation improved exercise capacity, adherence, and health-related quality of life. Most included studies were judged to have some concerns about risk of bias, while one study demonstrated an overall low risk of bias. The findings suggest that digital health technologies are effective adjuncts or alternatives to conventional physiotherapy, enhancing accessibility, patient engagement, and rehabilitation outcomes. However, further high-quality multicenter RCTs with standardized intervention protocols and longer follow-up periods are required to strengthen the evidence base and support wider implementation in routine physiotherapy practice.