Effectiveness of guided telerehabilitation on functional performance in community-dwelling older adults: A systematic review.

The interventions were so different in content, duration, frequency, and delivery mode that no meta-analysis was possible, so there is no single pooled effect to rely on. Twenty-one of the 26 included studies were rated as having some or high risk of bias, most commonly in deviations from intended interventions and selection of reported results. All but four studies excluded participants with additional exercise-limiting comorbidities, so the findings may not apply to your frailer, more complex patients. Three studies required a minimum level of digital literacy, which limits generalisability to older adults who are less comfortable with technology. Blinding of participants and therapists was not possible in most trials, which is a known challenge for rehabilitation studies. The review was conducted at a point when post-pandemic policies had expanded telehealth access, and the authors note this may influence the findings.

The authors declared no conflicts of interest and received no financial support for the research, authorship, or publication.

Do not read this as proof that telerehabilitation outperforms in-person care for all older adults. Only 11 of the 26 trials found a significant advantage for telerehabilitation, the overall evidence quality was rated low to moderate, and 21 of 26 studies had some or high risk of bias. The interventions varied so widely in content and delivery that no pooled estimate was possible, so you cannot yet generalise the result to a specific programme design.