Real-time telerehabilitation for the treatment of musculoskeletal conditions is effective and comparable to standard practice: a systematic review and meta-analysis
Real-time telerehabilitation for the treatment of musculoskeletal conditions is effective and comparable to standard practice: a systematic review and meta-analysis
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DOI：
10.1177/0269215516645148
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发表时间：
2017-05-01
影响因子：
3
通讯作者：
Russell, Trevor G.
中科院分区：
文献类型：
--
作者：
Cottrell, Michelle A.;Galea, Olivia A.;Russell, Trevor G.
目的：评估通过实时远程康复治疗来管理肌肉骨骼疾病的有效性，并确定实时远程康复治疗是否与该人群中的传统治疗方法具有可比性。数据来源：从成立到 2015 年 11 月，检索了六个数据库（Medline、Embase、Cochrane CENTRAL、PEDro、psycINFO、CINAHL），查找报告实时远程康复治疗结果的文献。肌肉骨骼疾病的远程康复。审查方法：两名审查员筛选了 5913 份摘要，其中 13 项研究 (n = 1520) 符合资格标准。使用 Downs & Black 质量测量清单工具评估方法学质量。根据主要结果指标汇总结果进行荟萃分析，并报告为标准化平均差和 95% 置信区间 (CI)。结果：综合结果表明远程康复可有效改善身体功能（SMD 1.63，95%CI 0.92-2.33，I-2=93%），同时稍微有利一些（SMD 0.44，95%CI 0.19-0.69， I-2=58%) 高于干预后的对照组。亚组分析显示，在常规护理的基础上进行远程康复（SMD 0.64，95% CI 0.43-0.85，I-2 = 10%）比单独进行常规护理更有利，而单独通过远程康复提供的治疗在改善身体功能方面相当于面对面干预（SMD MD 0.14，95% CI -0.10-0.37，I-2 = 0%）。干预后，各队列之间的疼痛改善情况也具有可比性（SMD 0.66，95%CI -0.27-1.60，I-2=96%）。 结论：实时远程康复对于改善各种肌肉骨骼疾病的身体功能和疼痛来说似乎是有效的，并且与传统的医疗保健方法相当。
Objective: To evaluate the effectiveness of treatment delivered via real-time telerehabilitation for the management of musculoskeletal conditions, and to determine if real-time telerehabilitation is comparable to conventional methods of delivery within this population.Data sources: Six databases (Medline, Embase, Cochrane CENTRAL, PEDro, psycINFO, CINAHL) were searched from inception to November 2015 for literature which reported on the outcomes of real-time telerehabilitation for musculoskeletal conditions.Review methods: Two reviewers screened 5913 abstracts where 13 studies (n = 1520) met the eligibility criteria. Methodological quality was assessed using the Downs & Black Checklist for Measuring Quality' tool. Results were pooled for meta-analysis based upon primary outcome measures and reported as standardised mean differences and 95% confidence intervals (CI).Results: Aggregate results suggest that telerehabilitation is effective in the improvement of physical function (SMD 1.63, 95%CI 0.92-2.33, I-2=93%), whilst being slightly more favourable (SMD 0.44, 95%CI 0.19-0.69, I-2=58%) than the control cohort following intervention. Sub-group analyses reveals that telerehabilitation in addition to usual care is more favourable (SMD 0.64, 95%CI 0.43-0.85, I-2=10%) than usual care alone, whilst treatment delivered solely via telerehabilitation is equivalent to face-to-face intervention (SMD MD 0.14, 95% CI -0.10-0.37, I-2 = 0%) for the improvement of physical function. The improvement of pain was also seen to be comparable between cohorts (SMD 0.66, 95%CI -0.27-1.60, I-2=96%) following intervention.Conclusions: Real-time telerehabilitation appears to be effective and comparable to conventional methods of healthcare delivery for the improvement of physical function and pain in a variety of musculoskeletal conditions.