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Introduction: The aim of this review was to systematically evaluate the available evidence on the effectiveness of internet-based telerehabilitation among patients after total joint arthroplasty regarding pain, range of motion, physical function, health-related quality of life, satisfaction, and psychological well-being., Methods: This was a systematic review with meta-analysis based on the Cochrane Handbook for Systematic Reviews of Interventions guidelines. Studies published in English or Chinese were searched using defined search periods, databases, and search terms. Two reviewers assessed independently the quality of studies. RevMan 5.3 was used for meta-analysis. Heterogeneity was assessed using the χ 2 and I 2 statistic. A random effect model and mean difference (MD) with 95% confidence interval (CI) was adopted. Standardised mean difference (SMD) was used if the outcome was measured by different scales., Results: Eleven studies with 1020 participants were analysed. Compared to face-to-face rehabilitation, internet-based telerehabilitation showed no significant difference in outcomes of pain (SMD-0.11, 95% CI-0.32 to 0.10), range of motion in flexion (MD 0.65, 95% CI-1.18 to 2.48) and extension (MD-0.38, 95% CI-1.16 to 0.40), patient-reported physical function (SMD 0.01, 95% CI-0.15 to 0.17), health-related quality of life (SMD-0.09, 95% CI-0.26 to 0.07), satisfaction (SMD-0.04, 95% CI-0.21 to 0.14), and psychological well-being (SMD 0.10, 95% CI-0.13 to 0.33). Internet-based telerehabilitation showed better outcomes in physical functional tests (SMD-0.54, 95% CI-1.08 to-0.01)., Discussion: This review suggests that internet-based telerehabilitation has comparable effectiveness to face-to-face rehabilitation on rehabilitation outcomes among patients after total joint arthroplasty.

Background: Total joint arthroplasty is one of the most commonly performed orthopaedic procedures globally. Telerehabilitation has recently been used as a supplement or an alternative to face-to-face rehabilitation services among patients after total joint arthroplasty., Objectives: To synthesise the evidence on the effectiveness of internet-based telerehabilitation regarding pain relief, range of motion, physical function, health-related quality of life, self-efficacy, psychological well-being/problems, and satisfaction among patients after total joint arthroplasty., Methods: An integrative review was conducted using defined search periods, databases, and search terms. This review adopted a five-stage approach: problem identification, literature search, data evaluation, data analysis and presentation. Studies published in English and Chinese were included. The Mixed Methods Appraisal Tool was used to assess the quality of included studies., Results: Twenty-two eligible studies with 1,179 participants were included in this review. Nineteen of them were conducted in North America, Europe and Australia, and three in China. There were 20 quantitative and two qualitative studies. Synchronous mode using videoconferencing (n = 11) was predominant in the studies between 2003 and 2017, while asynchronous mode using mobile apps (n = 7) has become the main mode since 2017. Internet-based telerehabilitation was delivered by physiotherapists in 17 studies and by nurses in three. Most of the included studies reported that, compared to face-to-face rehabilitation, internet-based telerehabilitation showed a comparable improvement in pain relief, range of motion, physical function, and health-related quality of life. Patients had a high satisfaction level. Very few studies addressed the patients' psychological well-being/problems and self-efficacy as the outcome measures., Conclusions: Internet-based telerehabilitation appears to be effective for and accepted by patients after total joint arthroplasty. Telerehabilitation could be delivered by nurses in collaboration with physiotherapists and surgeons as a team. The mobile app is an accessible and flexible delivery medium for telerehabilitation. Robust randomised controlled trials are warranted to enhance the quality of evidence on the effectiveness of mobile app-based telerehabilitation and nurse-delivered program. Qualitative components are suggested to be included in future research. Psychological outcomes should also be measured., Competing Interests: Declaration of Competing Interest None., (Copyright © 2020. Published by Elsevier Ltd.)

Aims and Objectives: To obtain an in‐depth understanding of the specific needs of patients for rehabilitation services delivered via mobile applications after total hip or knee arthroplasty. Background: Due to increased demand for arthroplasty, the provision of face‐to‐face rehabilitation services for patients is becoming challenging. New approaches using digital technologies are being developed, such as mobile applications to deliver rehabilitation services. However, the perspectives of patients on the delivery of these services via mobile applications after total hip or knee arthroplasty have not been explored extensively. Design: A qualitative descriptive study. Methods: Twenty patients who had been discharged from the hospital after a total hip or knee arthroplasty were interviewed via telephone about their needs regarding the future use of mobile applications to conduct arthroplasty rehabilitation. Interview records were transcribed verbatim and analysed using inductive content analysis. Reporting of the findings complies with the COREQ checklist for qualitative studies. Results: Four categories emerged from the data collected from the participants: (1) assisting rehabilitation self‐management, (2) facilitating peer support, (3) facilitating contact with healthcare professionals and (4) supporting emotional well‐being. Conclusions: The study provided an in‐depth understanding of the specific needs of patients for rehabilitation services delivered via mobile applications after total hip or knee arthroplasty. The findings of the study could be used in the development or revision of mobile application rehabilitation programmes to better support the rehabilitation of patients. Future studies are needed to evaluate the effectiveness of such programmes, especially including the self‐efficacy of patients as an outcome measure. Relevance to clinical practice: From the perspective of patients who have undergone arthroplasty, a mobile application rehabilitation programme should encourage patients in rehabilitation self‐management, assist them to contact healthcare professionals and other patients and support their postoperative emotional well‐being. The study findings will assist nurses with the preparation and delivery of telerehabilitation programmes after arthroplasty. [ABSTRACT FROM AUTHOR]

Total hip arthroplasty and total knee arthroplasty are widely performed worldwide. Patients undergoing total hip or knee arthroplasty are often discharged after a short hospital stay. Using information and communication technologies, such as mobile applications, to provide rehabilitation services remotely may be a strategy to support patients' postoperative recovery. This study aimed to evaluate the effectiveness of a rehabilitation programme delivered via a mobile application among Chinese patients after total hip or knee arthroplasty. Randomised controlled trial. A teaching hospital in Shanghai, China. Eighty-six patients who received a unilateral primary total hip or knee arthroplasty. The participants were recruited in the hospital and randomised into either the experimental or control group. Once discharged from the hospital, the control group (n = 43) received usual care, and the experimental group (n = 43) received usual care plus a 6-week mobile rehabilitation programme. Outcomes were assessed three times: the day before hospital discharge and 6 and 10 weeks after discharge. Primary outcomes were the changes in scores of self-efficacy and patient-reported physical function from baseline to 6 weeks post-discharge. Secondary outcomes included changes in scores of pain, depression, anxiety, and health-related quality of life. Data were analysed using generalised estimating equations. At 6 weeks after hospital discharge, the experimental group showed statistically significant improvements compared to the control in scores of self-efficacy (adjusted mean difference = 0.72, 95% CI 0.31 to 1.14, P <.001) and patient-reported physical function (adjusted mean difference = 4.57, 95% CI 1.24 to 7.90, P =.007). The between-group difference in self-efficacy probably reached clinical significance. At week-10 follow-up, the experimental group had statistically significant improvements in scores of self-efficacy (adjusted mean difference = 0.64, 95% CI 0.33 to 0.95, P <.001), health-related quality of life (adjusted mean difference = 0.06, 95% CI 0.01 to 0.10, P =.018), anxiety (adjusted mean difference = − 0.51, 95% CI − 0.91 to − 0.10, P =.015), and depression (adjusted mean difference = − 0.37, 95% CI − 0.66 to − 0.08, P =.012). The between-group difference in self-efficacy and health-related quality of life may be clinically significant. Mobile application-based rehabilitation demonstrated potentially positive effects on patients' self-efficacy, patient-reported physical function, health-related quality of life, and levels of anxiety and depression. Registered with the Australian New Zealand Clinical Trials Registry on 6 July 2021 (ACTRN12621000867897). [ABSTRACT FROM AUTHOR]