TY  - JOUR
AU  - Xiang, Xiao-Na
AU  - Wang, Ze-Zhang
AU  - Hu, Jing
AU  - Zhang, Jiang-Yin
AU  - Li, Ke
AU  - Chen, Qi-Xu
AU  - Xu, Fa-Shu
AU  - Zhang, Yue-Wen
AU  - He, Hong-Chen
AU  - He, Cheng-Qi
AU  - Zhu, Si-Yi
PY  - 2024
DA  - 2024/8/2
TI  - Telehealth-Supported Exercise or Physical Activity Programs for Knee Osteoarthritis: Systematic Review and Meta-Analysis
JO  - J Med Internet Res
SP  - e54876
VL  - 26
KW  - telehealth
KW  - knee osteoarthritis
KW  - physical activities
KW  - quality of life
KW  - systematic review and meta-analysis
KW  - systematic review
KW  - meta-analysis
KW  - knee
KW  - physical activity
KW  - exercise
KW  - chronic disease
KW  - chronic disease management
KW  - effectiveness
KW  - physical function
KW  - self-efficacy
AB  - 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. Trial Registration: PROSPERO CRD42022359658; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=359658 
SN  - 1438-8871
UR  - https://www.jmir.org/2024/1/e54876
UR  - https://doi.org/10.2196/54876
DO  - 10.2196/54876
ID  - info:doi/10.2196/54876
ER  -