背景:在慢性病管理中整合远程医疗支持的计划已变得越来越普遍。然而,其对膝骨关节炎(KOA)患者的疗效尚不清楚.
目的:本研究旨在评估远程健康支持的运动或身体活动计划对KOA患者的有效性。
方法:包括Embase,MEDLINE,中部,WebofScience,PubMed,Scopus,PEDro,GreyNet,和medRxiv从开始到2023年9月进行,以确定将远程健康支持的运动或身体活动计划与KOA的对照条件进行比较的随机对照试验.在符合条件的研究中提取并定性合成数据,并进行荟萃分析以评估疗效.该研究是根据PRISMA(系统审查和荟萃分析的首选报告项目)2020报告的。
结果:总计,23项研究符合资格标准,20个纳入荟萃分析。结果显示,远程健康支持的运动或体育锻炼计划可以减轻疼痛(g=-0.39;95%CI-0.67至-0.11;P<.001),改善体力活动(g=0.13;95%CI0.03-0.23;P=0.01),和增强的身体功能(g=-0.51;95%CI-0.98至-0.05;P=0.03)。此外,生活质量显著改善(g=0.25;95%CI0.14-0.36;P<.001),疼痛自我效能(g=0.72;95%CI0.53-0.91;P<.001),观察到整体改善(比值比2.69,95%CI1.41-5.15;P<.001)。然而,身体功能自我效能(g=0.14;95%CI-0.26~0.53;P=.50)无显著改善.基于世界卫生组织数字健康分类的亚组分析(疼痛:χ22=6.5;P=.04,身体功能:χ22=6.4;P=.04),干预组的远程技术类型(疼痛:χ24=4.8;P=.31,功能:χ24=13.0;P=.01),和活动或非活动对照组(疼痛:χ21=5.3;P=.02和身体功能:χ21=3.4;P=.07)显示出显着的亚组差异。
结论:远程健康支持的运动或体育锻炼计划可能会减轻膝盖疼痛并改善体育锻炼,物理功能,生活质量,自我效能感,以及KOA个人的全球进步。未来的研究应考虑更长的实施持续时间,并评估将可穿戴设备和标准化组件纳入大规模干预措施以评估效果的可行性。
背景:PROSPEROCRD42022359658;https://www.crd.约克。AC.uk/prospro/display_record.php?RecordID=359658。
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.
BACKGROUND: PROSPERO CRD42022359658; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=359658.