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Meta-Analysis
. 2022 Sep 28:10:954754.
doi: 10.3389/fpubh.2022.954754. eCollection 2022.

Do patients with and survivors of COVID-19 benefit from telerehabilitation? A meta-analysis of randomized controlled trials

Jiapeng Huang  1   2   3 , Ye Fan  4   5 , Kehong Zhao  1   2   3 , Chunlan Yang  1   2   3 , Ziqi Zhao  1   2   3 , Yin Chen  1   2   3 , Jiaen Yang  1   2   3   6 , Tingting Wang  1   2   3 , Yun Qu  1   2   3
Affiliations
Meta-Analysis

Do patients with and survivors of COVID-19 benefit from telerehabilitation? A meta-analysis of randomized controlled trials

Jiapeng Huang et al. Front Public Health. .

Abstract

Background: Coronavirus disease 2019 (COVID-19) significantly impacts physical, psychological, and social functioning and reduces quality of life, which may persist for at least 6 months. Given the fact that COVID-19 is a highly infectious disease and therefore healthcare facilities may be sources of contagion, new methods avoiding face-to-face contact between healthcare workers and patients are urgently needed. Telerehabilitation is the provision of rehabilitation services to patients at a distance via information and communication technologies. However, high-quality evidence of the efficacy of telerehabilitation for COVID-19 is still lacking. This meta-analysis aimed to investigate the efficacy of telerehabilitation for patients with and survivors of COVID-19.

Methods: We searched the Cochrane Library, EMBASE, Medline (via PubMed), PEDro, ClinicalTrials.gov, and WHO International Clinical Trials Registry Platform from January 1st, 2020 to April 30th, 2022 for randomized controlled trials published in English, which aimed to evaluate the efficacy of telerehabilitation vs. face-to-face rehabilitation, usual care, or no treatment for COVID-19. Methodological quality and overall evidence quality of the included studies were assessed. The statistical reliability of the data was quantified using the trial sequential analysis.

Results: Seven randomized controlled trials with eight comparisons were included and all of them were used for meta-analysis. The meta-analyses of absolute values showed the superiority of telerehabilitation over no treatment or usual care for dyspnea (Borg scale: mean difference = -1.88, -2.37 to -1.39; Multidimensional dyspnea-12: mean difference = -3.70, -5.93 to -1.48), limb muscle strength (mean difference = 3.29; 2.12 to 4.47), ambulation capacity (standardized mean difference = 0.88; 0.62 to 1.14), and depression (mean difference = -5.68; -8.62 to -2.74). Significant improvement in these variables persisted in the meta-analyses of change scores. No significant difference was found in anxiety and quality of life. No severe adverse events were reported in any of the included studies.

Conclusions: Moderate- to very low-quality evidence demonstrates that telerehabilitation may be an effective and safe solution for patients with and survivors of COVID-19 in dyspnea, lower limb muscle strength, ambulation capacity, and depression. Further well-designed studies are required to evaluate the long-term effects, cost-effectiveness, and satisfaction in larger samples.

Keywords: COVID-19; eHealth; meta-analysis; physical function; psychological function; telemedicine; telerehabilitation.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram for search strategy and study selection.
Figure 2
Figure 2
Forest plot analyses of the efficacy of telerehabilitation for (A) Borg scale and (B) Multidimensional dyspnea-12 questionnaire.
Figure 3
Figure 3
Forest plot analyses of the efficacy of telerehabilitation for (A) 30-s sit-to-stand test and (B) Six-min walking test.
Figure 4
Figure 4
Forest plot analyses of the efficacy of telerehabilitation for (A) Hamilton depression rating scale and (B) Hamilton anxiety rating scale.
See this image and copyright information in PMC

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