Evidence of benefit from telerehabilitation in routine care: a systematic review

Abstract

We systematically reviewed the evidence on the effectiveness of telerehabilitation (TR) applications. The review included reports on rehabilitation for any disability, other than mental health conditions, and drug or alcohol addiction. All forms of telecommunications technology for TR and all types of study design were considered. Study quality was assessed using an approach that considered both study performance and study design. Judgements were made on whether each TR application had been successful, whether reported outcomes were clinically significant, and whether further data were needed to establish the application as suitable for routine use. Sixty-one scientifically credible studies that reported patient outcomes or administrative changes were identified through computerized literature searches on five databases. Twelve clinical categories were covered by the studies. Those dealing with cardiac or neurological rehabilitation were the most numerous. Thirty-one of the studies (51%) were of high or good quality. Study results showed that 71% of the TR applications were successful, 18% were unsuccessful and for 11% the status was unclear. The reported outcomes for 51% of the applications appeared to be clinically significant. Poorer-quality studies tended to have worse outcomes than those from high- or good-quality studies. We judged that further study was required for 62% of the TR applications and desirable for 23%. TR shows promise in many fields, but compelling evidence of benefit and of impact on routine rehabilitation programmes is still limited. There is a need for more detailed, better-quality studies and for studies on the use of TR in routine care.

Telerehabilitation and recovery of motor function: a systematic review and meta-analysis

“…Second, a broad connectivity coverage is needed to reach most users at home. To date, reviews of the scientific literature on telerehabilitation are qualitative syntheses mainly addressing issues related to neurological rehabilitation [11][12][13][14] . Recently, Laver and colleagues published the first systematic review with meta-analysis of telerehabilitation services for stroke 15 .…”

Development and implementation of technologies for physical telerehabilitation in Latin America:

“…In the area of physiotherapy, the use of telemonitoring technologies has been proposed as an alternative for providing affordable functional rehabilitation services and reducing hospital overloads, thus removing some space-time constraints [8], [9]. A retrospective study with 155 patients and 155 control subjects shown that the costs of hospital bed days of care (1,449 days) in the year before the implementation of telerehabilitation programs totaled approximately $1,500,000, which decreased more than around $804,000 the year following the implementation of the telerehabilitation program, which represents a 46% decrease in costs and a decrease of 826 days of care [10].…”

“…Besides, the charges depend on the cost of living in each country, a fact that makes more difficult to estimate constant economic benefits of telerehabilitation. Therefore, the cost effectiveness of telerehabilitation programs has been evaluated for a specific disability, as described in [8]- [10], [12]. Thus, telerehabilitation is still considered a growing alternative to traditional face-to-face therapy that employs technological solutions to remotely provide rehabilitation care in both clinical centers and in-home programs.…”

Telehealth in Nephrology Care—Promises and Challenges

“…A definition of success for a telemedicine application is that it performs as well as a similar alternative intervention, or better than the alternative if the telemedicine option includes additional services. 16 In the study by Ishani et al details were not available on services provided by usual care so that the success of their initiative is not entirely clear. If the intervention was more elaborate, economic analysis would be required to inform clinical and policy decisions.…”