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Meta-Analysis
. 2024 Aug 2:26:e54876.
doi: 10.2196/54876.

Telehealth-Supported Exercise or Physical Activity Programs for Knee Osteoarthritis: Systematic Review and Meta-Analysis

Xiao-Na Xiang #  1   2   3 , Ze-Zhang Wang #  1   2   3 , Jing Hu  1   2   3 , Jiang-Yin Zhang  1   2   3 , Ke Li  4   5 , Qi-Xu Chen  4   5 , Fa-Shu Xu  6 , Yue-Wen Zhang  4   5 , Hong-Chen He  1   2   3 , Cheng-Qi He  1   2   3 , Si-Yi Zhu  1   2   3
Affiliations
Meta-Analysis

Telehealth-Supported Exercise or Physical Activity Programs for Knee Osteoarthritis: Systematic Review and Meta-Analysis

Xiao-Na Xiang et al. J Med Internet Res. .

Abstract

Background: The integration of telehealth-supported programs in chronic disease management has become increasingly common. However, its effectiveness for individuals with knee osteoarthritis (KOA) remains unclear.

Objective: This study aimed to assess the effectiveness of telehealth-supported exercise or physical activity programs for individuals with KOA.

Methods: A comprehensive literature search encompassing Embase, MEDLINE, CENTRAL, Web of Science, PubMed, Scopus, PEDro, GreyNet, and medRxiv from inception to September 2023 was conducted to identify randomized controlled trials comparing telehealth-supported exercise or physical activity programs to a control condition for KOA. Data were extracted and qualitatively synthesized across eligible studies, and a meta-analysis was performed to evaluate the effects. The study was reported according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020.

Results: In total, 23 studies met eligibility criteria, with 20 included in the meta-analysis. Results showed that telehealth-supported exercise or physical activity programs reduced pain (g=-0.39; 95% CI -0.67 to -0.11; P<.001), improved physical activity (g=0.13; 95% CI 0.03-0.23; P=.01), and enhanced physical function (g=-0.51; 95% CI -0.98 to -0.05; P=.03). Moreover, significant improvements in quality of life (g=0.25; 95% CI 0.14-0.36; P<.001), self-efficacy for pain (g=0.72; 95% CI 0.53-0.91; P<.001), and global improvement (odds ratio 2.69, 95% CI 1.41-5.15; P<.001) were observed. However, self-efficacy for physical function (g=0.14; 95% CI -0.26 to 0.53; P=.50) showed insignificant improvements. Subgroup analyses based on the World Health Organization classification of digital health (pain: χ22=6.5; P=.04 and physical function: χ22=6.4; P=.04), the type of teletechnology in the intervention group (pain: χ24=4.8; P=.31 and function: χ24=13.0; P=.01), and active or inactive controls (pain: χ21=5.3; P=.02 and physical function: χ21=3.4; P=.07) showed significant subgroup differences.

Conclusions: Telehealth-supported exercise or physical activity programs might reduce knee pain and improve physical activity, physical function, quality of life, self-efficacy, and global improvement in individuals with KOA. Future research should consider longer implementation durations and assess the feasibility of incorporating wearables and standardized components into large-scale interventions to evaluate the effects.

Trial registration: PROSPERO CRD42022359658; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=359658.

Keywords: chronic disease; chronic disease management; effectiveness; exercise; knee; knee osteoarthritis; meta-analysis; physical activities; physical activity; physical function; quality of life; self-efficacy; systematic review; systematic review and meta-analysis; telehealth.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Flow diagram describing the literature review process. PICOS: Participants, Intervention, Comparison, Outcome, and Study Design; RCT: randomized controlled trial.
Figure 2
Figure 2
Forest plot of (A) pain, (B) physical activity, and (C) physical function.
Figure 3
Figure 3
Subgroup analysis of (A) pain and (B) physical function based on the World Health Organization classification.
Figure 4
Figure 4
Subgroup analysis of (A) pain and (B) physical function based on the type of digital technology.
Figure 5
Figure 5
Subgroup analysis of (A) pain and (B) physical function based on the control group.
See this image and copyright information in PMC

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