ROLE OF TELEREHABILITATION IN PATIENTS FOLLOWING TOTAL KNEE ARTHROPLASTY- EVIDENCE FROM SYSTEMATIC LITERATURE REVIEW

OBJECTIVES: Increased physical activity and functional ability are the goals of total knee replacement surgery. Therefore, adequate rehabilitation is required for the recovery of patients after discharge from hospital following total knee arthroplasty (TKA). This systematic literature review aims to evaluate the effectiveness of home telerehabilitation in patients who underwent TKA. METHODS: Studies published in the English language between 2000 and 2014 were retrieved from Embase, PubMed and Cochrane databases using relevant search strategies. Two researchers independently reviewed studies as per the Cochrane methodology for systematic reviews. We considered telerehabilitation sessions as those that were conducted using videoconferencing by experienced physiotherapists to patients’ home via an internet connection. The outcomes assessed include knee movement (knee extension and flexion); quadriceps muscle strength; functional assessment (the timed up-and-go test); assessment of pain, stiffness and functional capacity with Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and visual analog scale (VAS) for pain. RESULTS: In total, 160 potentially relevant studies were screened. Following screening of studies as abstracts and full-text publications, seven primary publications (four randomized controlled trials [RCT], one non-RCT, and two single arm trials) were included in the review. Patients experienced high levels of satisfaction with the use of telerehabilitation alone. The patients in the home telerehabilitation group showed improvement in physical activity and functional status similar to patients in conventional therapy group (comparative studies).  The detailed analyses of the findings from studies are still ongoing and will be presented on completion. CONCLUSIONS: A preliminary analysis shows that home telerehabilitation method is an acceptable rehabilitation method to patients who underwent TKA. The evidence from this systematic literature review will hopefully demonstrate telerehabilitation to be a practical alternative to conventional face-to-face rehabilitation therapy in patients who underwent TKA.