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The Efficacy of Electronic Health–Supported Home Exercise Interventions for Patients With Osteoarthritis of the Knee: Systematic Review

Last updated: 05-27-2020

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The Efficacy of Electronic Health–Supported Home Exercise Interventions for Patients With Osteoarthritis of the Knee: Systematic Review

PMID: 29699963
The Efficacy of Electronic Health–Supported Home Exercise Interventions for Patients With Osteoarthritis of the Knee: Systematic Review
Monitoring Editor: Gunther Eysenbach
1 Christoff Zalpour , MD,2 Harry von Piekartz , PhD,2 Toby Maxwell Hall , PhD,3 and Volker Paelke , PhD4
1 Course of Study Speech and Language Therapy, Occupational Therapy and Physiotherapy, Faculty of Social Work and Health, University of Applied Sciences and Arts Hildesheim, Hildesheim, Germany
2 Institut für angewandte Physiotherapie und Osteopathie, Fakultät Wirtschafts- und Sozialwissenschaften, University of Applied Sciences Osnabrück, Osnabrück, Germany
3 School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Australia
4 International Degree Programme in Media Computer Science, Electrical Engineering and Computer Science, University of Applied Sciences Bremen, Bremen, Germany
Axel Georg Meender Schäfer, Course of Study Speech and Language Therapy, Occupational Therapy and Physiotherapy, Faculty of Social Work and Health, University of Applied Sciences and Arts Hildesheim, Gebaeude Goschentor, 2nd Floor, Goschentor 1, Hildesheim, 31141, Germany, Phone: 49 5121 881 ext 510, Email: ed.kwah@refeahcs.lexa .
Axel Georg Meender Schäfer
1 Course of Study Speech and Language Therapy, Occupational Therapy and Physiotherapy, Faculty of Social Work and Health, University of Applied Sciences and Arts Hildesheim, Hildesheim, Germany
Find articles by Axel Georg Meender Schäfer
Christoff Zalpour
2 Institut für angewandte Physiotherapie und Osteopathie, Fakultät Wirtschafts- und Sozialwissenschaften, University of Applied Sciences Osnabrück, Osnabrück, Germany
Find articles by Christoff Zalpour
Harry von Piekartz
2 Institut für angewandte Physiotherapie und Osteopathie, Fakultät Wirtschafts- und Sozialwissenschaften, University of Applied Sciences Osnabrück, Osnabrück, Germany
Find articles by Harry von Piekartz
Toby Maxwell Hall
Find articles by Toby Maxwell Hall
Volker Paelke
4 International Degree Programme in Media Computer Science, Electrical Engineering and Computer Science, University of Applied Sciences Bremen, Bremen, Germany
Corresponding author.
Corresponding Author: Axel Georg Meender Schäfer ed.kwah@refeahcs.lexa
Received 2017 Nov 27; Revisions requested 2018 Jan 17; Revised 2018 Feb 7; Accepted 2018 Feb 11.
Copyright ©Axel Georg Meender Schäfer, Christoff Zalpour, Harry von Piekartz, Toby Maxwell Hall, Volker Paelke. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 26.04.2018.
This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/ ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/ , as well as this copyright and license information must be included.
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Associated Data
GUID: 501E5BAC-BE95-4394-B5AF-6562849C1F52
Multimedia Appendix 3.
Electronic health (eHealth)-supported exercise compared with no or other interventions for knee osteoarthritis GRADE summary of findings table.
Abstract
Background
Osteoarthritis of the knee is the most common cause for disability and limited mobility in the elderly, with considerable individual suffering and high direct and indirect disease-related costs. Nonsurgical interventions such as exercise, enhanced physical activity, and self-management have shown beneficial effects for pain reduction, physical function, and quality of life (QoL), but access to these treatments may be limited. Therefore, home therapy is strongly recommended. However, adherence to these programs is low. Patients report lack of motivation, feedback, and personal interaction as the main barriers to home therapy adherence. To overcome these barriers, electronic health (eHealth) is seen as a promising opportunity. Although beneficial effects have been shown in the literature for other chronic diseases such as chronic pain, cardiovascular disease, and diabetes, a systematic literature review on the efficacy of eHealth interventions for patients with osteoarthritis of knee is missing so far.
Objective
The aim of this study was to compare the efficacy of eHealth-supported home exercise interventions with no or other interventions regarding pain, physical function, and health-related QoL in patients with osteoarthritis of the knee.
Methods
MEDLINE, CENTRAL, CINAHL, and PEDro were systematically searched using the keywords osteoarthritis knee, eHealth, and exercise. An inverse variance random-effects meta-analysis was carried out pooling standardized mean differences (SMDs) of individual studies. The Cochrane tool was used to assess risk of bias in individual studies, and the quality of evidence across studies was evaluated following the Grading of Recommendations, Assessment, Development, and Evaluation approach.
Results
The literature search yielded a total of 648 results. After screening of titles, abstracts, and full-texts, seven randomized controlled trials were included. Pooling the data of individual studies demonstrated beneficial short-term (pain SMD=−0.31, 95% CI −0.58 to −0.04, low quality; QoL SMD=0.24, 95% CI 0.05-0.43, moderate quality) and long-term effects (pain −0.30, 95% CI −0.07 to −0.53, moderate quality; physical function 0.41, 95% CI 0.17-0.64, high quality; and QoL SMD=0.27, 95% CI 0.06-0.47, high quality).
Conclusions
eHealth-supported exercise interventions resulted in less pain, improved physical function, and health-related QoL compared with no or other interventions; however, these improvements were small (SMD


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