Telerehabilitation solutions in patient pathways: An overview of systematic reviews

Abstract

Background: Telerehabilitation (TR), a branch of telemedicine, provides remote therapeutic rehabilitation through telecommunication. Driven by technological advances and benefits like remote monitoring and patient education, it has grown since 1998. The Coronavirus Disease 2019 (COVID-19) pandemic highlighted its importance in maintaining healthcare access.

Research question: What is the efficacy of TR compared to in-person rehabilitation? Are the assessment tools effective? Is TR well-accepted, and are costs reduced?

Methods: A bibliographic search on Medline, Cochrane and Google Scholar focused on systematic reviews (SRs) from 2014 to Mai 2024, comparing TR or home-based rehabilitation with in person treatments for various conditions. Independent reviewers conducted initial screenings, resolving disagreements by a third reviewer. Joanna Briggs Institute Critical Appraisal Checklist was used to evaluate the quality of review. The data was synthesised narratively.

Results: The search identified 665 SRs. After selection, 228 SR were included. TR models include synchronous (real-time video interactions), asynchronous (independent sessions through digital platforms) and mixed methods. Regardless of the medical fields, the conclusions of the SRs consistently point to the equivalence of TR compared to in-person rehabilitation. Remote evaluations via digital tools were reliable and valid for various assessments. TR is cost effectiveness and well accepted.

Conclusions: TR is a viable alternative or complement to traditional rehabilitation, offering enhanced accessibility, reduced costs and improved results. Barriers include technical issues, training and concerns about lack of physical contact. Mixed methods could address these challenges.

Keywords: Telerehabilitation; blended; remote assessment; review of systematic reviews.

Figure 1.

Reporting items for systematic reviews flow diagram of the study selection process.