Preprint · May 28, 2025
Effectiveness of exercise-based telerehabilitation in older patients with knee osteoarthritis: a systematic review and meta-analysis (Preprint)
By He X, Zhou H, Jiang Y et al.
BACKGROUND Osteoarthritis (OA), a degenerative joint disease affecting over 300 million globally, predominantly impacts the elderly through knee-related disability and chronic pain. Exercise rehabilitation effectively alleviates symptoms and improves function but faces accessibility barriers in resource-limited settings. Mobile health (mHealth) technologies, including telerehabilitation, offer scalable solutions by overcoming geographical constraints. However, elderly patients’ limited technology acceptance raises uncertainty about its efficacy . This study evaluates exercise-based telerehabilitation outcomes in older adults with knee OA to address healthcare inequities and optimize evidence-based interventions. OBJECTIVE This study is to investigate the impact of exercise-based telerehabilitation on pain, physical function, and quality of life in elderly adults afflicted with knee osteoarthritis (OA). METHODS We performed a systematic review and analysis of randomized controlled trials (RCTs) examining exercise-based telerehabilitation in comparison to standard care or no intervention. A thorough search was conducted in Medline, Embase, Web of Science, and the Cochrane Library for randomized controlled trials concerning exercise-based telerehabilitation in elderly individuals with knee osteoarthritis, up to April 2025. The Cochrane Risk of Bias tool was utilized to assess the risk of bias. RESULTS A total of six studies involving 568 participants with an average age of 64.11 ± 0.78 years were identified. These RCTs were conducted between 2016 and 2025. The findings indicated that exercise-based telerehabilitation led to a significant reduction in pain intensity (standardized mean difference, SMD: 1.01, 95% confidence interval, CI: 0.16 to 1.85), an enhancement in physical function (SMD: 1.07, 95% CI: 0.16 to 1.99), and an improvement in quality of life (SMD: 0.95, 95% CI: 0.05 to 1.84) for elderly individuals with knee OA. Furthermore, subgroup analyses, which categorized the studies by publication year and intervention duration, revealed significant differences in pain alleviation among the various groups. CONCLUSIONS Exercise-based telerehabilitation has proven to be a successful therapeutic approach for knee OA in older persons, offering a realistic alternative for this demographic. Nevertheless, additional research with larger sample numbers and more rigorous methodologies is necessary to reinforce these conclusions.