title: Real-time telerehabilitation for the treatment of musculoskeletal conditions is effective and comparable to standard practice: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To evaluate the effectiveness of treatment delivered via real-time telerehabilitation for the management of musculoskeletal conditions, and to determine if real-time telerehabilitation is comparable to conventional methods of delivery within this population.
  
  
  METHODS
  Six databases (Medline, Embase, Cochrane CENTRAL, PEDro, psycINFO, CINAHL) were searched from inception to November 2015 for literature which reported on the outcomes of real-time telerehabilitation for musculoskeletal conditions.
  
  
  METHODS
  Two reviewers screened 5913 abstracts where 13 studies ( n = 1520) met the eligibility criteria. Methodological quality was assessed using the Downs & Black 'Checklist for Measuring Quality' tool. Results were pooled for meta-analysis based upon primary outcome measures and reported as standardised mean differences and 95% confidence intervals (CI).
  
  
  RESULTS
  Aggregate results suggest that telerehabilitation is effective in the improvement of physical function (SMD 1.63, 95%CI 0.92-2.33, I2=93%), whilst being slightly more favourable (SMD 0.44, 95%CI 0.19-0.69, I2=58%) than the control cohort following intervention. Sub-group analyses reveals that telerehabilitation in addition to usual care is more favourable (SMD 0.64, 95%CI 0.43-0.85, I2=10%) than usual care alone, whilst treatment delivered solely via telerehabilitation is equivalent to face-to-face intervention (SMD MD 0.14, 95% CI -0.10-0.37, I2= 0%) for the improvement of physical function. The improvement of pain was also seen to be comparable between cohorts (SMD 0.66, 95%CI -0.27-1.60, I2=96%) following intervention.
  
  
  CONCLUSIONS
  Real-time telerehabilitation appears to be effective and comparable to conventional methods of healthcare delivery for the improvement of physical function and pain in a variety of musculoskeletal conditions.
authors.affiliation: 1 School of Health and Rehabilitation Science, University of Queensland, Australia.|2 Centre for Research Excellence in Telehealth, University of Queensland, Australia.
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Cottrell
authors.affiliation: 1 School of Health and Rehabilitation Science, University of Queensland, Australia.
authors.forename: Olivia A
authors.initials: OA
authors.lastname: Galea
authors.affiliation: 1 School of Health and Rehabilitation Science, University of Queensland, Australia.|3 Physiotherapy Department, Royal Brisbane and Women's Hospital, Australia.
authors.forename: Shaun P
authors.initials: SP
authors.lastname: O'Leary
authors.affiliation: 1 School of Health and Rehabilitation Science, University of Queensland, Australia.|2 Centre for Research Excellence in Telehealth, University of Queensland, Australia.
authors.forename: Anne J
authors.initials: AJ
authors.lastname: Hill
authors.affiliation: 1 School of Health and Rehabilitation Science, University of Queensland, Australia.|2 Centre for Research Excellence in Telehealth, University of Queensland, Australia.
authors.forename: Trevor G
authors.initials: TG
authors.lastname: Russell
mesh_terms: D006801:Humans; D009140:Musculoskeletal Diseases / Q000534:rehabilitation*; D000069350:Telerehabilitation / Q000379:methods / Q000592:standards*
keywords: Musculoskeletal disorders; Telemedicine; systematic review; telerehabilitation