Introduction: Total knee arthroplasty is a common orthopaedic procedure. Telerehabilitation is a form of remote rehabilitation that may improve access to physiotherapy services for patients after total knee arthroplasty. Purpose: This diploma thesis reviewed randomized controlled trials and compared the effects of telerehabilitation programmes and conventional physiotherapy after total knee arthroplasty on pain, range of motion, muscle performance, functional mobility, balance, knee function, quality of life, satisfaction, adherence and safety. Studies in which telerehabilitation replaced conventional physiotherapy were considered separately from studies in which it was used as an adjunct. Methods: The literature search was conducted in PubMed and PEDro. Studies were included if they were published in English after 2016, included participants after total knee arthroplasty (with the exception of one study that included patients who had total hip or knee arthroplasty in its sample) and compared telerehabilitation programmes with conventional physiotherapy or examined telerehabilitation as an adjunct to conventional physiotherapy. Studies with short-, medium- and long-term follow-up were included. Results: Nine studies were reviewed and analysed. Five studies examined telerehabilitation as a replacement for conventional physiotherapy and four examined it as an adjunct to conventional physiotherapy. Individual studies reported statistically significant effects of telerehabilitation on pain, isometric quadriceps strength, daily step count, quality of life, self-efficacy and adherence; however, most studies found no statistically significant between-group differences for most functional outcomes. In the study that combined online monitoring with supervised sensorimotor exercise, the observed effects cannot be attributed solely to telerehabilitation. Similarly, the results of a study involving patients who had total hip or knee arthroplasty are not directly comparable to other studies. Discussion and conclusion: In selected patients after total knee arthroplasty, telerehabilitation was comparable with conventional physiotherapy for most outcomes. Several factors limit the generalizability of the results, primarily the small number of included studies, the methodological and content-related heterogeneity of telerehabilitation programs, the diversity of the measurement tools used and the inconsistent duration of patient follow-up. The possible effect on costs remains unclear, as economic outcomes were not systematically assessed in the included studies. Larger randomized controlled trials using consistent outcome measures and longer follow-up are needed to determine the effectiveness of telerehabilitation after total knee arthroplasty more reliably.
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