Postoperative Telerehabilitation in Patients With Hip Fracture: Systematic Review and Meta-Analysis

TL;DR

This study reviews how telerehabilitation helps hip fracture patients recover after surgery, finding it beneficial but with limited evidence.

Contribution

The paper provides a systematic review and meta-analysis of postoperative telerehabilitation's effects on hip fracture recovery, addressing prior inconsistent findings.

Findings

Telerehabilitation improved hip function scores (Harris Hip Score) at the end of treatment.

It enhanced functional mobility and daily living abilities in both short- and long-term follow-ups.

Results showed significant improvements in timed up and go tests and physical performance battery scores.

Abstract

Telerehabilitation programs use information and communications technologies to facilitate exercise training, self-management education, and health behavior modifications for nonhospitalized patients. In recent years, 2 systematic reviews have examined the effectiveness of telerehabilitation in the recovery of patients with hip fractures but have yielded inconsistent results. This is a significant gap because tools to assess clinical domains such as pain, range of motion, and deformity are crucial for patient outcomes. Moreover, the long-term effects of telerehabilitation on postoperative functional recovery in patients with hip fractures have not been investigated.

To address the abovementioned research gap, this systematic review aimed to evaluate the short- and long-term effects of telerehabilitation on postoperative functional recovery in patients with hip fractures.

We searched the PubMed, Cochrane Library, Embase, and Web of Science databases from inception to March 31, 2025. Randomized controlled trials investigating the effect of postoperative telerehabilitation in patients with hip fractures were included in this systematic review. Outcomes of interest included hip function measured using the Harris Hip Score; functional mobility measured using the Short Physical Performance Battery and the timed up and go test; and ability to perform basic activities of daily living measured using the Functional Independence Measure, Barthel index, or modified Barthel index. Meta-analyses were performed using the RevMan software (version 5.3).

A thorough literature search conducted in April 2025 yielded a total of 8 studies involving 740 patients for inclusion in this systematic review. Meta-analysis showed that telerehabilitation was effective for improving the Harris Hip Score at the intervention end point (2 included studies involving 156 participants; mean difference [MD] 7.42, 95% CI 5.61-9.23; P<.001; I2=3%), the Short Physical Performance Battery score at the end point (4 included studies involving 430 participants; MD 1.34, 95% CI 1.14-1.55; P<.001; I2=33%) and at follow-up (2 included studies involving 292 participants; MD 1.17, 95% CI 1.00-1.34; P<.001; I2=0%), the timed up and go score at the end point (4 included studies involving 156 participants; MD –8.45, 95% CI −11.28 to −5.62; P<.001; I2=0%) and at follow-up (2 included studies involving 63 participants; MD −7.66, 95% CI −13.78 to −1.53; P=.01; I2=0%), and ability to perform basic activities of daily living at the end point (5 included studies involving 354 participants; standardized MD 1.65, 95% CI 0.78-2.51; P<.001; I2=91%) and at follow-up (standardized MD 0.43, 95% CI 0.05-0.81; P=.03; I2=48%).

Our review found that postoperative telerehabilitation may benefit short- and long-term functional recovery in patients with hip fractures compared to conventional rehabilitation. However, the evidence was weak due to the limited number and insufficient quality of the included studies and the heterogeneity across the studies.

Figures