Xiao Huangyi, Zeng Wenshu, Lu Lanmo, Yuan Jiankun, Yan Ziyu, Wang Jun
The Affiliated Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Municipal Health Commission Key Laboratory of Oral Biomedical Engineering, Chongqing Medical University, Chongqing, 400000, China.
School of nursing, Yunnan University of Chinese Medicine, Kunming Yunnan, 650000, China.
BMC Sports Sci Med Rehabil. 2025 May 26;17(1):130. doi: 10.1186/s13102-025-01169-4.
To comprehensively assess the rehabilitation efficacy of telerehabilitation compared with other traditional rehabilitation therapies in postoperative hip fracture patients.
Seven electronic databases: PubMed, Embase, The Cochrane Library, Web of Science, CNKI, Wan Fang, and VIP Databases, were searched from inception until October 2023.
Two independent reviewers selected randomized controlled trials (RCTs) that assessed the efficacy of telerehabilitation intervention approach to postoperative hip fracture rehabilitation. An outcome measure related to hip function, functional independence, anxiety levels, walking ability, quality of life, and treatment adherence were eligible.
Two reviewers independently used the Cochrane Risk of Bias 2 (RoB 2) tool for risk of bias and data extraction. RevMan 5.4 and Stata 15.1 were used for statistical analysis.
Seventeen RCTs (n = 1577) met the inclusion criteria. Compared to the usual care group, the telerehabilitation group demonstrated a noteworthy enhancement in hip function, as evidenced by the Harris Hip Score (SMD = 1.05, 95% CI (0.64, 1.45)). Significant improvements in functional independence (Functional Independence Measure: SMD = 1.38, 95% CI (1.08, 1.68)), adherence to rehabilitation treatment (Medical Compliance Behavior Scale: SMD = 1.23, 95% CI (0.71, 1.76)), and quality of life (SMD = 1.04, 95% CI (0.42, 1.65)) were also observed in the telerehabilitation group. However, no statistically significant distinction was observed in anxiety improvement (as assessed by the Self-Rating Anxiety Scale: SMD = -0.67, 95%CI (-1.65, 0.31)) or in terms of walkability (Timed Up and Go Test: SMD = -0.06, 95% CI (-0.32, 0.20)) when compared to the usual care group. This may be related to patient participation, differences in telerehabilitation interventions, and inconsistent follow-up durations among different studies.
Current evidence suggests that telerehabilitation may help improve hip function, increase functional independence, and improve treatment adherence in patients after hip fracture surgery. Nonetheless, it does not demonstrate a significant impact on reducing patients' anxiety or improving their walking ability.
全面评估远程康复与其他传统康复疗法相比，对髋部骨折术后患者的康复效果。
检索了7个电子数据库，即PubMed、Embase、Cochrane图书馆、Web of Science、中国知网、万方数据库和维普数据库，检索时间从建库至2023年10月。
两名独立评审员筛选评估远程康复干预方法对髋部骨折术后康复效果的随机对照试验（RCT）。与髋部功能、功能独立性、焦虑水平、行走能力、生活质量和治疗依从性相关的结果指标均符合要求。
两名评审员独立使用Cochrane偏倚风险2（RoB 2）工具进行偏倚风险评估和数据提取。使用RevMan 5.4和Stata 15.1进行统计分析。
17项RCT（n = 1577）符合纳入标准。与常规护理组相比，远程康复组的髋部功能有显著改善，Harris髋关节评分证明了这一点（标准化均数差（SMD）= 1.05，95%可信区间（CI）（0.64，1.45））。远程康复组在功能独立性（功能独立性测量：SMD = 1.38，95%CI（1.08，1.68））、康复治疗依从性（医疗依从行为量表：SMD = 1.23，95%CI（0.71，1.76））和生活质量（SMD = 1.04，95%CI（0.42，1.65））方面也有显著改善。然而，与常规护理组相比，在焦虑改善（通过自评焦虑量表评估：SMD = -0.67，95%CI（-1.65，0.31））或行走能力方面（计时起立行走测试：SMD = -0.06，95%CI（-0.32，0.20））未观察到统计学上的显著差异。这可能与患者参与度、远程康复干预的差异以及不同研究中随访时间不一致有关。
目前的证据表明，远程康复可能有助于改善髋部骨折手术后患者的髋部功能，提高功能独立性，并改善治疗依从性。尽管如此，它并未显示出对减轻患者焦虑或改善其行走能力有显著影响。
