1 Centre for Rehabilitation Research in Oxford, University of Oxford, UK.
2 8955 Oxford Health NHS Foundation Trust , UK.
J Telemed Telecare. 2019 Jun;25(5):263-275. doi: 10.1177/1357633X18768400. Epub 2018 Apr 18.
Rehabilitation approaches for people with rheumatoid arthritis include joint protection, exercises and self-management strategies. Health interventions delivered via the web have the potential to improve access to health services overcoming time constraints, physical limitations, and socioeconomic and geographic barriers. The objective of this review is to determine the effects of web-based rehabilitation interventions in adults with rheumatoid arthritis.
Randomised controlled trials that compared web-based rehabilitation interventions with usual care, waiting list, no treatment or another web-based intervention in adults with rheumatoid arthritis were included. The outcomes were pain, function, quality of life, self-efficacy, rheumatoid arthritis knowledge, physical activity and adverse effects. Methodological quality was assessed using the Cochrane Risk of Bias tool and quality of evidence with the Grading of Recommendations Assessment, Development and Evaluation approach.
Six source documents from four trials ( n = 567) focusing on self-management, health information or physical activity were identified. The effects of web-based rehabilitation interventions on pain, function, quality of life, self-efficacy, rheumatoid arthritis knowledge and physical activity are uncertain because of the very low quality of evidence mostly from small single trials. Adverse effects were not reported.
Large, well-designed trials are needed to evaluate the clinical and cost-effectiveness of web-based rehabilitation interventions in rheumatoid arthritis.
类风湿关节炎患者的康复方法包括关节保护、运动和自我管理策略。通过网络提供的健康干预措施有可能改善获得医疗服务的机会，克服时间限制、身体限制以及社会经济和地理障碍。本综述的目的是确定基于网络的康复干预措施对类风湿关节炎成人患者的影响。
纳入了比较基于网络的康复干预与常规护理、等待名单、无治疗或其他基于网络的干预在类风湿关节炎成人患者中的随机对照试验。结果是疼痛、功能、生活质量、自我效能、类风湿关节炎知识、身体活动和不良反应。使用 Cochrane 偏倚风险工具评估方法学质量，并使用推荐评估、制定和评估方法评估证据质量。
确定了四项试验中的六份原始文件（n=567），这些试验重点关注自我管理、健康信息或身体活动。由于大多数来自小的单一试验，证据质量极低，因此基于网络的康复干预对疼痛、功能、生活质量、自我效能、类风湿关节炎知识和身体活动的影响尚不确定。未报告不良反应。
需要进行大型、精心设计的试验来评估基于网络的康复干预在类风湿关节炎中的临床和成本效益。
