@Article{info:doi/10.2196/54876,
author="Xiang, Xiao-Na
and Wang, Ze-Zhang
and Hu, Jing
and Zhang, Jiang-Yin
and Li, Ke
and Chen, Qi-Xu
and Xu, Fa-Shu
and Zhang, Yue-Wen
and He, Hong-Chen
and He, Cheng-Qi
and Zhu, Si-Yi",
title="Telehealth-Supported Exercise or Physical Activity Programs for Knee Osteoarthritis: Systematic Review and Meta-Analysis",
journal="J Med Internet Res",
year="2024",
month="Aug",
day="2",
volume="26",
pages="e54876",
keywords="telehealth; knee osteoarthritis; physical activities; quality of life; systematic review and meta-analysis; systematic review; meta-analysis; knee; physical activity; exercise; chronic disease; chronic disease management; effectiveness; physical function; self-efficacy",
abstract="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: $\chi$22=6.5; P=.04 and physical function: $\chi$22=6.4; P=.04), the type of teletechnology in the intervention group (pain: $\chi$24=4.8; P=.31 and function: $\chi$24=13.0; P=.01), and active or inactive controls (pain: $\chi$21=5.3; P=.02 and physical function: $\chi$21=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. Trial Registration: PROSPERO CRD42022359658; https://www.crd.york.ac.uk/prospero/display{\_}record.php?RecordID=359658 ",
issn="1438-8871",
doi="10.2196/54876",
url="https://www.jmir.org/2024/1/e54876",
url="https://doi.org/10.2196/54876"
}