Effectiveness of biofeedback-assisted asynchronous telerehabilitation in musculoskeletal care: A systematic review

Abstract

Background Musculoskeletal conditions are the leading cause of disability worldwide. Telerehabilitation may be a viable option in the management of these conditions, facilitating access and patient adherence. Nevertheless, the impact of biofeedback-assisted asynchronous telerehabilitation remains unknown. Objective To systematically review and assess the effectiveness of exercise-based asynchronous biofeedback-assisted telerehabilitation on pain and function in individuals with musculoskeletal conditions. Methods This systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The search was conducted using three databases: PubMed, Scopus, and PEDro. Study criteria included articles written in English and published from January 2017 to August 2022, reporting interventional trials evaluating exercise-based asynchronous telerehabilitation using biofeedback in adults with musculoskeletal disorders. The risks of bias and certainty of evidence were appraised using the Cochrane tool and Grading of Recommendations, Assessment, Development, and Evaluation (GRADE), respectively. The results are narratively summarized, and the effect sizes of the main outcomes were calculated. Results Fourteen trials were included: 10 using motion tracker technology ( N = 1284) and four with camera-based biofeedback ( N = 467). Telerehabilitation with motion trackers yields at least similar improvements in pain and function in people with musculoskeletal conditions (effect sizes: 0.19–1.45; low certainty of evidence). Uncertain evidence exists for the effectiveness of camera-based telerehabilitation (effect sizes: 0.11–0.13; very low evidence). No study found superior results in a control group. Conclusions Asynchronous telerehabilitation may be an option in the management of musculoskeletal conditions. Considering its potential for scalability and access democratization, additional high-quality research is needed to address long-term outcomes, comparativeness, and cost-effectiveness and identify treatment responders.

Digital therapeutics-based lumbar core exercise for patients with low back pain: A prospective exploratory pilot study

“… 36 – 40 This finding is consistent with research showing that education and communication are related to better long-term outcomes during physical therapy. 41 , 42 Additionally, digital therapeutics can improve patient compliance and retention by promoting impressive user experience. 43 , 44 …”

Kas iskelet sistemi hastalıklarında telerehabilitasyon

“…Kas-iskelet sistemi ile ilişkili omuz rahatsızlığı yaşayan hastalara yardımcı olan basit video konferans sistemlerinden, karmaşık sensör tabanlı teknolojilere kadar çeşitli teknolojik rehabilitasyon araçları bulunmaktadır (Elgert et al, 2021). Telerehabilitasyon kapsamında sadece asenkron biofeedback yöntemi kullanılarak uygulanan, giyilebilir sensörler veya mobil sağlık aplikasyonları kullanımlarını içeren çalışmaları inceleyen bir çalışmada telerehabilitasyonun kas iskelet sistemi hastalıklarında hastalıklara geri bildirim kullanılarak uygulanan tedavi programlarının iyi bir alternatif olabileceğini bildirmişlerdir (Janela et al, 2023).…”