BACKGROUND: The integration of telehealth-supported programs in chronic disease management has become increasingly common. However, its effectiveness for individuals with knee osteoarthritis (KOA) remains unclear. OBJECTIVE: This study aimed to assess the effectiveness of telehealth-supported exercise or physical activity programs for individuals with KOA. METHODS: A comprehensive literature search encompassing Embase, MEDLINE, CENTRAL, Web of Science, PubMed, Scopus, PEDro, GreyNet, and medRxiv from inception to September 2023 was conducted to identify randomized controlled trials comparing telehealth-supported exercise or physical activity programs to a control condition for KOA. Data were extracted and qualitatively synthesized across eligible studies, and a meta-analysis was performed to evaluate the effects. The study was reported according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020. RESULTS: In total, 23 studies met eligibility criteria, with 20 included in the meta-analysis. Results showed that telehealth-supported exercise or physical activity programs reduced pain (g -0.39; 95% CI -0.67 to -0.11; p < 0.001), improved physical activity (g 0.13; 95% CI 0.03 to 0.23; p = 0.01), and enhanced physical function (g -0.51; 95% CI -0.98 to -0.05; p = 0.03). Moreover, significant improvements in quality of life (g 0.25; 95% CI 0.14 to 0.36; p < 0.001), self-efficacy for pain (g 0.72; 95% CI 0.53 to 0.91; p < 0.001), and global improvement (odds ratio 2.69, 95% CI 1.41 to 5.15; p < 0.001) were observed. However, self-efficacy for physical function (g 0.14; 95% CI -0.26 to 0.53; p = 0.50) showed insignificant improvements. Subgroup analyses based on the World Health Organization classification of digital health (pain: chi22 6.5; p = 0.04 and physical function: chi22 6.4; p = 0.04), the type of teletechnology in the intervention group (pain: chi24 4.8; p = 0.31 and function: chi24 13.0; p = 0.01), and active or inactive controls (pain: chi21 5.3; p = 0.02 and physical function: chi21 3.4; p = 0.07) showed significant subgroup differences. CONCLUSIONS: Telehealth-supported exercise or physical activity programs might reduce knee pain and improve physical activity, physical function, quality of life, self-efficacy, and global improvement in individuals with KOA. Future research should consider longer implementation durations and assess the feasibility of incorporating wearables and standardized components into large-scale interventions to evaluate the effects. TRIAL REGISTRATION: PROSPERO CRD42022359658; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID= 359658.

Full text (sometimes free) may be available at these link(s):      help

• PubMed Central
• DOI
• PubMed
• PDF locator
• publisher