Shnitzer Hila, Chan Josh, Yau Thomas, McIntyre McKyla, Andreoli Angie, Kua Ailene, Bayley Mark, Leochico Carl Froilan, Guo Meiqi, Munce Sarah
Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.
Western University, London, ON, Canada.
JMIR Rehabil Assist Technol. 2025 Jul 9;12:e68681. doi: 10.2196/68681.
Telerehabilitation involves the delivery of rehabilitation services over a distance through communication technologies. In contrast to traditional in-person rehabilitation, telerehabilitation can help overcome barriers including geographic distance and facility use. There is evidence to suggest that telerehabilitation can lead to increased patient engagement and adherence to treatment plans. However, limited research exists on the association of telerehabilitation with adverse events, potentially hindering its broader adoption and use in health care.
This systematic review of randomized controlled trials aims to summarize existing research on adverse events related to telerehabilitation delivery.
This review was conducted according to the methodological framework outlined by the Joanna Briggs Institute. Studies were identified from MEDLINE ALL, Embase, APA PsycINFO, CENTRAL, and CINAHL. Included studies were randomized controlled trials published between 2013 and 2023, written in English, and had no geographic or delivery mode restrictions. Data extraction used the TIDieR (Template for Intervention Description and Replication) framework, along with authors, publication year, sample size, specific telerehabilitation modes, and the incidence, type, severity, and relatedness of reported adverse events. Methodological quality was assessed using the Cochrane risk of bias tool, and the certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation tool.
Search results identified 9022 references, of which 37 randomized controlled trials met the criteria for inclusion. There were a total of 3166 participants, with a mean age of 57.4 (SD 11.3) years, and 1023 (32.3%) being female participants. Various delivery modes were used, with videoconferencing emerging as the most frequently used method. A total of 201 adverse events were recorded during 65,352 sessions (0.31% or 3.1 per 1000 sessions). These events were predominantly physical (eg, falls and palpitations), nonserious or mild, and not directly attributed to the telerehabilitation intervention. Additionally, 34 (92%) of included studies implemented various safety practices including vital sign monitoring, safety checklists, and scheduled check-ins with study personnel.
This review demonstrates that telerehabilitation exhibits a generally safe profile as an alternative to in-person rehabilitation, with most reported adverse events being rare, nonserious or mild, and unrelated to telerehabilitation protocols. However, more extensive research with detailed reporting on adverse event characteristics is needed. Moreover, future research should evaluate the effectiveness of different safety practices and their association with adverse events. An enhanced understanding of potential risks in telerehabilitation can foster broader adoption while ensuring its safe implementation among health care providers and patients.
远程康复是指通过通信技术远程提供康复服务。与传统的面对面康复相比，远程康复有助于克服包括地理距离和设施使用等障碍。有证据表明，远程康复可提高患者的参与度并增强其对治疗计划的依从性。然而，关于远程康复与不良事件之间关联的研究有限，这可能会阻碍其在医疗保健领域更广泛地被采用和使用。
本对随机对照试验的系统评价旨在总结现有关于远程康复服务相关不良事件的研究。
本评价依据乔安娜·布里格斯研究所概述的方法框架进行。研究从MEDLINE ALL、Embase、APA PsycINFO、CENTRAL和CINAHL中检索。纳入的研究为2013年至2023年发表的随机对照试验，英文撰写，且无地理或服务模式限制。数据提取采用TIDieR（干预描述与复制模板）框架，同时提取作者、发表年份、样本量、特定的远程康复模式以及报告的不良事件的发生率、类型、严重程度和相关性。采用Cochrane偏倚风险工具评估方法学质量，使用推荐分级评估、制定和评价工具评估证据的确定性。
检索结果共识别出9022篇参考文献，其中37项随机对照试验符合纳入标准。共有3166名参与者，平均年龄57.4（标准差11.3）岁，女性参与者1023名（32.3%）。采用了多种服务模式，视频会议成为最常用的方法。在65352次疗程中共记录到201起不良事件（0.31%或每1000次疗程3.1起）。这些事件主要为身体方面的（如跌倒和心悸），不严重或为轻度，且并非直接归因于远程康复干预。此外，纳入研究中的34项（92%）实施了各种安全措施，包括生命体征监测、安全检查表以及与研究人员定期进行检查。
本评价表明，作为面对面康复的替代方式，远程康复总体上显示出安全的特征，大多数报告的不良事件罕见、不严重或为轻度，且与远程康复方案无关。然而，需要开展更广泛的研究，并详细报告不良事件特征。此外，未来的研究应评估不同安全措施的有效性及其与不良事件的关联。对远程康复潜在风险的深入了解有助于更广泛地采用，同时确保其在医疗保健提供者和患者中安全实施。
