The Effectiveness Of Internet Based Exercise For Decreasing Pain And Improving Muscle Strength In Adults With Knee Osteoarthritis: A Systematic Review

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2023-04-03

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Background: Osteoarthritis (OA) is the most prevalent joint disorder and the fourth leading cause of disability worldwide. Knees are the most commonly affected joints of OA. Internet-based exercise (IBE) is a telerehabilitation approach which combines monitoring, guidance and treatment for patients with OA of the knee. Although previous systematic reviews have investigated the effect of treating knee OA patients with IBE, none have included muscle strength as an outcome. Therefore, this review aimed to collate, evaluate and synthesise the available literature on the effects of IBE on pain and muscle strength in adults with knee OA. It also aimed to determine whether IBE is more effective than the usual care (UC) methods. Study design: Systematic review with a narrative synthesis Methodology: A systematic search of six randomised control trials (RCTs) was conducted between 20 October 2022 and 30 October 2022 using the following databases: Web of Science, EMBASE, AMED, Scopus, PEDro, CINAHL and Medline. All six RCTs were evaluated for inclusion and methodological quality by two independent reviewers. A narrative synthesis was used due to the high level of heterogeneity among the studies. Results: Six moderate- to high-quality RCTs, including a total of 1176 patients with knee OA, were analysed. All six studies reported statistically significant improvements in pain and muscle strength post-IBE intervention (P = 0.001). In addition, these improvements in the IBE groups were statistically significant when compared to those of the non-exercise control groups (P = 0.001). However, no statistically significant differences were observed between IBE and UC. Conclusion: The literature indicates that IBE is effective for reducing pain and improving muscle strength in patients with knee OA. In addition, IBE was found to have greater efficacy than UC in studies of this population. However, these findings should be regarded with caution due to the limitations and heterogeneity of the research.

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Keywords: Osteoarthritis, knee, internet-based exercise, telerehabilitatio

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