Effects of Exercise-Based Telerehabilitation for Knee Osteoarthritis: A Systematic Review and a Study Protocol

Background: Knee osteoarthritis causes considerable pain and disability. Telerehabilitation has emerged as a promising treatment option, especially after the Coronavirus Disease 2019 pandemic, but it still faces challenges regarding solid scientific evidence about its multiple benefits. This systematic review aimed to analyze the reported beneficial effects of telerehabilitation based on therapeutic exercise for the management of knee osteoarthritis. Methodsː PubMed, PEDro, Web of Science and Cochrane Library databases were used to identify eligible studies. This review followed the PRISMA guidelines and was registered at PROSPERO (n° CRD42024579836). The selected studies underwent a qualitative assessment using the Modified Jadad Score. Results: Ten studies, including a total of 1354 participants, were included. From the selected studies, a wide variety of outcome measures emerged to evaluate the efficacy of telerehabilitation in the relief of pain and its clinical consequences. Seven studies specifically assessed pain, with four showing significant improvements in pain reduction in the intervention group compared with the control group. Telerehabilitation was found to be more effective or non-inferior to traditional rehabilitation in relieving pain, as reported across various pain scales. Limitations include the heterogeneity of interventions, the exclusion of non-recent studies, and the exclusive focus on therapeutic exercise. Conclusionsː The results of this systematic review suggest that telerehabilitation provides pain relief, improves physical function, and enhances quality of life, while preliminary evidence indicates potential cost-related advantages. However, some studies did not find TR to be superior to control interventions, highlighting mixed evidence. Additional high-quality studies are required to better support this promising rehabilitation approach.