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Telerehabilitation for community-dwelling middle-aged and older adults after musculoskeletal trauma: A systematic review

1 Centre for Hip Health and Mobility, Vancouver, Canada
2 Department of Family Practice, The University of British Columbia, Canada
3 School of Psychology, The University of Adelaide, South Australia, Australia
4 School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
5 Baker Heart and Diabetes Institute, Melbourne, Australia
6 Alfred Emergency and Trauma Centre, Melbourne, Australia
7 Department of Family Medicine, University of Manitoba, Canada
8 Department of Natural Sciences, Health Psychology, Medical School Berlin, Germany
9 Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, South Australia, Australia
10 Vancouver Coastal Health, Canada
11 Department of Physical Therapy, The University of British Columbia, Canada
12 Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Spain; Institute for Biomedical Research (ibs), Granada, Spain
13 Department of Physical Medicine and Rehabilitation, Virgen de las Nieves University Hospital, Granada, Spain
14 PA-HELP “Physical Activity for HEaLth Promotion” Research Group. Department of Physiotherapy, University of Granada, Granada, Spain

Special Issues: Telerehabilitation for Adults and Older Adults

Background: Musculoskeletal trauma at midlife and beyond imposes significant impact on function and quality of life: Rehabilitation is key to support early and sustained recovery. There are frequent barriers to attending in-person rehabilitation that may be overcome by the recent advances in technology (telerehabilitation). Therefore, we conducted a systematic review of published evidence on telerehabilitation as a delivery mode for adults and older adults with musculoskeletal trauma. Methods: We followed established guidelines for conducting and reporting systematic reviews. We searched the following databases up to June 23, 2018: Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Embase, Google Scholar, MEDLINE (Ovid and PubMed), PsycINFO, and SportDiscus. We included publications across all available years and languages for community-dwelling adults (50 years and older) with musculoskeletal trauma; and interventions using the following delivery modes: Apps, computer, telephone, videophone, videoconference, webcam, webpage, or similar media. Results: Six studies met the inclusion criteria: Five studies for hip fracture (n = 260) and one study for proximal humeral fracture rehabilitation (n = 17). Four of the studies used telephone as the delivery mode, one used computer and another used video-conferencing. Two of the studies were pre-post with no comparator group, and the remaining four studies were randomized controlled trials with low or unclear risk of bias. Studies established some modes of remote delivery as feasible, but the generalizability of the findings were limited. Two studies observed significant between-group differences (favoring the intervention) for physical activity, quality of life, and self-efficacy. Conclusion: Very few studies exist that tested the effect of telerehabilitation for recovery after musculoskeletal trauma later in life. Given the global burden imposed by musculoskeletal trauma, this review underscores an important gap in clinical knowledge.
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Keywords systematic review; fracture; aging; telemedicine; technology; recovery

Citation: Maureen C. Ashe, Christina L. Ekegren, Anna M. Chudyk, Lena Fleig, Tiffany K. Gill, Dolores Langford, Lydia Martin-Martin, Patrocinio Ariza-Vega. Telerehabilitation for community-dwelling middle-aged and older adults after musculoskeletal trauma: A systematic review. AIMS Medical Science, 2018, 5(4): 316-336. doi: 10.3934/medsci.2018.4.316

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