University of Oulu

Jansson, M. M., Rantala, A., Miettunen, J., Puhto, A.-P., & Pikkarainen, M. (2022). The effects and safety of telerehabilitation in patients with lower-limb joint replacement: A systematic review and narrative synthesis. Journal of Telemedicine and Telecare, 28(2), 96–114.

The effects and safety of telerehabilitation in patients with lower-limb joint replacement : a systematic review and narrative synthesis

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Author: Jansson, Miia M1,2; Rantala, Arja1; Miettunen, Jouko3,4;
Organizations: 1Research Group of Medical Imaging, Physics and Technology, University of Oulu, Finland
2Oulu University Hospital, Finland
3Center for Life Course Health Research, University of Oulu, Finland
4Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland
5Division of Operative Care, Department of Orthopaedic and Trauma Surgery, Oulu University Hospital, Finland
6Martti Ahtisaari Institute, University of Oulu, Finland
7VTT, Technical Research Centre of Finland, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.9 MB)
Persistent link:
Language: English
Published: SAGE Publications, 2022
Publish Date: 2020-06-24


Introduction: As the number of patients undergoing primary lower-limb joint replacement has risen continuously, hospital-based healthcare resources have become limited. Delivery of any ongoing rehabilitation needs to adapt to this trend. This systematic literature aimed to examine the effects and safety of telerehabilitation in patients with lower-limb joint replacement.

Methods: A systematic review of randomized controlled trials was conducted according to procedures by the Joanna Briggs Institute. Studies published prior to February 2020 were identified from Medline Ovid, Scopus, Ebsco Databases and Web of Science. Reference lists of relevant studies were also manually checked to find additional studies. Two researchers conducted study selection separately. The Joanna Briggs Institute Critical Appraisal Checklist for Randomized Controlled Trials was used to evaluate the quality of the relevant studies published. A narrative synthesis was used to report the results whereas effect sizes were estimated for different outcomes.

Results: Nine studies with 1266 patients were included. Study quality was predominantly affected by the lack of blinding. The patients who completed telerehabilitation showed an improvement in physical functioning that was similar to that of patients completing conventional in-person outpatient physical therapy without an increase in adverse events or resource utilization. The effect of telerehabilitation on physical functioning, however, was assessed as heterogeneous and moderate- to low-quality evidence.

Discussion: Telerehabilitation is a practical alternative to conventional in-person outpatient physical therapy in patients with lower-limb joint replacement. However, more robust studies are needed to build evidence about telerehabilitation.

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Series: Journal of telemedicine and telecare
ISSN: 1357-633X
ISSN-E: 1758-1109
ISSN-L: 1357-633X
Volume: 28
Issue: 2
Pages: 96 - 114
DOI: 10.1177/1357633X20917868
Type of Publication: A2 Review article in a scientific journal
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Funding: This review has been supported by a grant from Business Finland as part of a project called “Intelligent Customer-driven Solution for Orthopedic and Pediatric Surgery Care.
Copyright information: © 2020 The Authros. Publishing rights Sage. The final authenticated version is available online