Gava Vander, Ribeiro Larissa Pechincha, Barreto Rodrigo Py Gonçalves, Camargo Paula Rezende
Department of Physical Therapy, Laboratory of Analysis and Intervention of the Shoulder Complex, 67828Universidade Federal de São Carlos, São Carlos, SP, Brazil.
Private Practice, Shoulder Clinic, Porto Alegre, RS, Brazil.
Clin Rehabil. 2022 Jun;36(6):715-725. doi: 10.1177/02692155221083496. Epub 2022 Mar 1.
To systematically review the effects of physical therapy given by telerehabilitation on pain and disability in individuals with shoulder pain.
PubMed, Embase, CINAHL, LILACS, Cochrane, Web of Science, SCOPUS, SciELO and Ibecs were searched in January/2022.
This systematic review followed PRISMA guidelines. Randomized controlled trials investigating the effects of physical therapy given by telerehabilitation on pain and disability in patients with shoulder pain were included. The quality and level of the evidence were assessed with the Cochrane Risk of Bias tool and GRADE, respectively. The effect sizes of the main outcomes were also calculated.
Six randomized controlled trials were included with a total sample of 368 patients with shoulder pain. Four and two randomized controlled trials were assessed as low and high risk of bias, respectively. Three randomized controlled trials assessed shoulder post-operative care, two assessed chronic shoulder pain, and one assessed frozen shoulder. Very low to low evidence suggests that there is no difference between telerehabilitation and in-person physical therapy or home-based exercises programs to improve pain and disability in patients with shoulder pain. Low evidence suggests that telerehabilitation is superior to advice only to improve shoulder pain (effect size: 2.42; 95% Confidence Interval: 1.72, 3.06) and disability (effect size: 1.61; 95% Confidence Interval: 1.01, 2.18).
Although telerehabilitation may be a promising tool to treat patients with shoulder pain and disability, the very low to low quality of evidence does not support a definite recommendation of its use in this population.
系统评价远程康复物理治疗对肩痛患者疼痛及功能障碍的影响。
于2022年1月检索了PubMed、Embase、CINAHL、LILACS、Cochrane、Web of Science、SCOPUS、SciELO和Ibecs。
本系统评价遵循PRISMA指南。纳入研究远程康复物理治疗对肩痛患者疼痛及功能障碍影响的随机对照试验。分别采用Cochrane偏倚风险工具和GRADE评估证据的质量和等级。还计算了主要结局的效应量。
纳入6项随机对照试验，共368例肩痛患者。4项和2项随机对照试验分别被评估为低偏倚风险和高偏倚风险。3项随机对照试验评估了肩部术后护理，2项评估了慢性肩痛，1项评估了肩周炎。极低到低质量的证据表明，远程康复与面对面物理治疗或家庭锻炼计划在改善肩痛患者的疼痛和功能障碍方面没有差异。低质量证据表明，远程康复在改善肩痛（效应量：2.42；95%置信区间：1.72，3.06）和功能障碍（效应量：1.61；95%置信区间：1.01，2.18）方面优于单纯建议。
尽管远程康复可能是治疗肩痛和功能障碍患者的一种有前景的工具，但极低到低质量的证据不支持在该人群中明确推荐使用。
