Faculty of Sport and Health Science, University of Jyväskylä, Jyväskylä, Finland; Department of Neurosciences, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium.
Faculty of Medicine, Department of Orthopaedics and Traumatology, University of Helsinki, Helsinki, Finland.
Arch Phys Med Rehabil. 2019 Jul;100(7):1339-1358. doi: 10.1016/j.apmr.2018.11.007. Epub 2018 Dec 6.
To study the effectiveness of technology-based distance physical rehabilitation interventions on physical functioning in stroke.
A systematic literature search was conducted in 6 databases from January 2000 to May 2018.
Inclusion criteria applied the patient, intervention, comparison, outcome, study design framework as follows: (P) stroke; (I) technology-based distance physical rehabilitation interventions; (C) any comparison without the use of technology; (O) physical functioning; (S) randomized controlled trials (RCTs). The search identified in total 693 studies, and the screening of 162 full-text studies revealed 13 eligible studies.
The studies were screened using the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines and assessed for methodological quality and quality of evidence. Meta-analysis was performed if applicable.
A total of 13 studies were included, and online video monitoring was the most used technology. Seven outcomes of physical functioning were identified-activities of daily living (ADL), upper extremity functioning, lower extremity functioning, balance, walking, physical activity, and participation. A meta-analysis of 6 RCTs indicated that technology-based distance physical rehabilitation had a similar effect on ADL (standard mean difference 0.06; 95% confidence interval: -0.22 to 0.35, P=.67) compared to the combination of traditional treatments (usual care, similar and other treatment). Similar results were obtained for other outcomes, except inconsistent findings were noted for walking. Methodological quality of the studies and quality of evidence were considered low.
The findings suggest that the effectiveness of technology-based distance physical rehabilitation interventions on physical functioning might be similar compared to traditional treatments in stroke. Further research should be performed to confirm the effectiveness of technology-based distance physical rehabilitation interventions for improving physical functioning of persons with stroke.
研究基于技术的远程物理康复干预对中风患者身体功能的影响。
系统检索了 2000 年 1 月至 2018 年 5 月的 6 个数据库。
纳入标准应用患者、干预、比较、结果、研究设计框架如下：（P）中风；（I）基于技术的远程物理康复干预；（C）任何不使用技术的比较；（O）身体功能；（S）随机对照试验（RCTs）。搜索共确定了 693 项研究，对 162 项全文研究的筛选显示有 13 项符合条件的研究。
使用系统评价和荟萃分析的首选报告项目对研究进行筛选，并评估方法学质量和证据质量。如果适用，则进行荟萃分析。
共纳入 13 项研究，在线视频监测是最常用的技术。确定了身体功能的 7 个结局指标——日常生活活动（ADL）、上肢功能、下肢功能、平衡、行走、身体活动和参与。对 6 项 RCT 的荟萃分析表明，与传统治疗（常规护理、相似和其他治疗）相比，基于技术的远程物理康复对 ADL 的效果相似（标准均数差 0.06；95%置信区间：-0.22 至 0.35，P=.67）。其他结局指标也得到了类似的结果，但行走的结果不一致。研究的方法学质量和证据质量被认为较低。
研究结果表明，与传统治疗相比，基于技术的远程物理康复干预对中风患者身体功能的效果可能相似。需要进一步研究以确认基于技术的远程物理康复干预对改善中风患者身体功能的有效性。
