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. 2021 Aug 19;23(8):e24015.
doi: 10.2196/24015.

eHealth in Geriatric Rehabilitation: Systematic Review of Effectiveness, Feasibility, and Usability

Jules J M Kraaijkamp  1   2 , Eléonore F van Dam van Isselt  1 , Anke Persoon  3 , Anke Versluis  1 , Niels H Chavannes  1 , Wilco P Achterberg  1
Affiliations

eHealth in Geriatric Rehabilitation: Systematic Review of Effectiveness, Feasibility, and Usability

Jules J M Kraaijkamp et al. J Med Internet Res. .

Abstract

Background: eHealth has the potential to improve outcomes such as physical activity or balance in older adults receiving geriatric rehabilitation. However, several challenges such as scarce evidence on effectiveness, feasibility, and usability hinder the successful implementation of eHealth in geriatric rehabilitation.

Objective: The aim of this systematic review was to assess evidence on the effectiveness, feasibility, and usability of eHealth interventions in older adults in geriatric rehabilitation.

Methods: We searched 7 databases for randomized controlled trials, nonrandomized studies, quantitative descriptive studies, qualitative research, and mixed methods studies that applied eHealth interventions during geriatric rehabilitation. Included studies investigated a combination of effectiveness, usability, and feasibility of eHealth in older patients who received geriatric rehabilitation, with a mean age of ≥70 years. Quality was assessed using the Mixed Methods Appraisal Tool and a narrative synthesis was conducted using a harvest plot.

Results: In total, 40 studies were selected, with clinical heterogeneity across studies. Of 40 studies, 15 studies (38%) found eHealth was at least as effective as non-eHealth interventions (56% of the 27 studies with a control group), 11 studies (41%) found eHealth interventions were more effective than non-eHealth interventions, and 1 study (4%) reported beneficial outcomes in favor of the non-eHealth interventions. Of 17 studies, 16 (94%) concluded that eHealth was feasible. However, high exclusion rates were reported in 7 studies of 40 (18%). Of 40 studies, 4 (10%) included outcomes related to usability and indicated that there were certain aging-related barriers to cognitive ability, physical ability, or perception, which led to difficulties in using eHealth.

Conclusions: eHealth can potentially improve rehabilitation outcomes for older patients receiving geriatric rehabilitation. Simple eHealth interventions were more likely to be feasible for older patients receiving geriatric rehabilitation, especially, in combination with another non-eHealth intervention. However, a lack of evidence on usability might hamper the implementation of eHealth. eHealth applications in geriatric rehabilitation show promise, but more research is required, including research with a focus on usability and participation.

Keywords: digital health; eHealth; effectiveness; feasibility; geriatric rehabilitation; mHealth; systematic review; usability.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
PRISMA flow diagram of search strategy results. ICF: International Classification of Functioning, Disability, and Health.
Figure 2
Figure 2
Quality appraisal for randomized controlled trial studies.
Figure 3
Figure 3
Quality appraisal for quantitative nonrandomized, qualitative, and mixed methods studies.
Figure 4
Figure 4
Outcome measures classified by the International Classification of Functioning, Disability, and Health model.
Figure 5
Figure 5
Harvest plot: effectiveness of eHealth interventions. MMAT: Mixed Methods Appraisal Tool.
See this image and copyright information in PMC

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