Telerehabilitation on the Physical and Functional Capacity of Traumatic Fractures of the Upper Limbs: A Systematic Review with Meta-Analysis

Authors

  • Guilherme Grivicich da Silva Rehabilitation Service, Hospital Cristo Redentor, Grupo Hospitalar Conceição (GHC), Porto Alegre, Rio Grande do Sul, Brazil
  • Francisco Xavier de Araújo Physical Therapy Department, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil. https://orcid.org/0000-0002-5637-4103
  • André Hillebrand Andriola Physical Therapy, Health School, University of Vale do Rio dos Sinos (UNISINOS), São Leopoldo, Rio Grande do Sul, Brazil https://orcid.org/0000-0003-4336-8705
  • Gustavo Costa Pereira Physical Therapy, Health School, University of Vale do Rio dos Sinos (UNISINOS), São Leopoldo, Rio Grande do Sul, Brazil https://orcid.org/0009-0003-7011-8469
  • Marcelo Faria Silva Physical Therapy Department, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil https://orcid.org/0000-0002-7894-5915

DOI:

https://doi.org/10.63144/ijt.2025.6667

Keywords:

Fractures, Functional capacity, Physical capacity, Telerehabilitation

Abstract

Traumatic injuries to the upper limbs, especially to the hands and wrists, have the potential to trigger chronic conditions with pain, loss of productivity and decreased quality of life. The aim of this study was to systematically review the literature on the effects of telerehabilitation on the physical and functional capacity of individuals with traumatic upper limbs fractures. Searches were conducted in the MEDLINE/PubMed, EMBASE, PEDRO, Cochrane, LILACS, and Science Direct databases. Three randomized clinical trials involving 830 patients with at least one intervention group and one comparison group were included in this systematic review. Risk of bias was assessed using the PEDro Scale and the certainty of the evidence was assessed using GRADE. Telerehabilitation seems to have favorable effects on functional capacity and pain perception and controversial effects on physical capacity (handgrip strength) in individuals with traumatic upper limb fractures.

 

 

  

References

Balshem, H., Helfand, M., Schünemann, H. J., Oxman, A. D., Kunz, R., Brozek, J., Vist, G. E., Falck-Ytter, Y., Meerpohl, J., & Norris, S. (2011). GRADE guidelines: 3. Rating the quality of evidence. Journal of Clinical Epidemiology, 64(4), 401–406. https://doi.org/10.1016/j.jclinepi.2010.07.015

Baroni, M. P., Jacob, M. F. A., Rios, W. R., Fandim, J. V., Fernandes, L. G., Chaves, P. I., Fioratti, I., & Saragiotto, B. T. (2023). The state of the art in telerehabilitation for musculoskeletal conditions. Archives of Physiotherapy, 13(1). https://doi.org/10.1186/s40945-022-00155-0

Bedra, M., & Finkelstein, J. (2015). Feasibility of post-acute hip fracture telerehabilitation in older adults. Studies in Health Technology and Informatics, 210, 469–473.

Bergh C, Wennergren D, Möller M, Brisby H (2020) Fracture incidence in adults in relation to age and gender: A study of 27,169 fractures in the Swedish Fracture Register in a well-defined catchment area. PLOS ONE 15(12), e0244291. https://doi.org/10.1371/journal.pone.0244291

Blanquero, J., Cortés-Vega, M. D., Rodríguez-Sánchez-Laulhé, P., Corrales-Serra, B. P., Gómez-Patricio, E., Díaz-Matas, N., & Suero-Pineda, A. (2020). Feedback-guided exercises performed on a tablet touchscreen improve return to work, function, strength and healthcare usage more than an exercise program prescribed on paper for people with wrist, hand or finger injuries: A randomised trial. Journal of Physiotherapy, 66(4), 236–242. https://doi.org/10.1016/j.jphys.2020.09.012

Bobos, P., Nazari, G., Lu, Z., & MacDermid, J. C. (2020). Measurement properties of the hand grip strength assessment: A systematic review with meta-analysis. Archives of Physical Medicine and Rehabilitation, 101(3), 553–565. https://doi.org/10.1016/j.apmr.2019.10.183

Bucki, F. M., Clay, M. B., Tobiczyk, H., & Green, B. N. (2021). Scoping review of telehealth for musculoskeletal disorders: Applications for the COVID-19 pandemic. Journal of Manipulative and Physiological Therapeutics, 44(7), 558–565. https://doi.org/10.1016/j.jmpt.2021.12.003

Carey, J. R., Durfee, W. K., Bhatt, E., Nagpal, A., Weinstein, S. A., Anderson, K. M., & Lewis, S. M. (2007). Comparison of finger tracking versus simple movement training via telerehabilitation to alter hand function and cortical reorganization after stroke. Neurorehabilitation and Neural Repair, 21(3), 216–232. https://doi.org/10.1177/1545968306292381

Cottrell, M. A., Galea, O. A., O’Leary, S. P., Hill, A. J., & Russell, T. G. (2017). Real-time telerehabilitation for the treatment of musculoskeletal conditions is effective and comparable to standard practice: A systematic review and meta-analysis. Clinical Rehabilitation, 31(5), 625–638). https://doi.org/10.1177/0269215516645148

Cottrell, M. A., & Russell, T. G. (2020). Telehealth for musculoskeletal physiotherapy. Musculoskeletal Science and Practice, 48, 102193. https://doi.org/10.1016/j.msksp.2020.102193

Crowe, C. S., Massenburg, B. B., Morrison, S. D., Chang, J., Friedrich, J. B., Abady, G. G., Alahdab, F., Alipour, V., Arabloo, J., Asaad, M., Banach, M., Bijani, A., Borzì, A. M., Briko, N. I., Castle, C. D., Cho, D. Y., Chung, M. T., Daryani, A., Demoz, G. T., … James, S. L. (2020). Global trends of hand and wrist trauma: a systematic analysis of fracture and digit amputation using the Global Burden of Disease 2017 Study. Injury Prevention, 26(Suppl 2), i115–i124. https://doi.org/10.1136/injuryprev-2019-043495

da Silva, N. C., Chaves, T. C., dos Santos, J. B., Sugano, R. M. M., Barbosa, R. I., Marcolino, A. M., Mazzer, N., & Fonseca, M. C. R. (2020). Reliability, validity and responsiveness of Brazilian version of QuickDASH. Musculoskeletal Science and Practice, 48, 102163. https://doi.org/10.1016/j.msksp.2020.102163

Guyatt, G. H., Oxman, A. D., Kunz, R., Brozek, J., Alonso-Coello, P., Rind, D., Devereaux, P. J., Montori, V. M., Freyschuss, B., Vist, G., Jaeschke, R., Williams, J. W., Murad, M. H., Sinclair, D., Falck-Ytter, Y., Meerpohl, J., Whittington, C., Thorlund, K., Andrews, J., & Schünemann, H. J. (2011). GRADE guidelines 6. Rating the quality of evidence - Imprecision. Journal of Clinical Epidemiology, 64(12), 1283–1293. https://doi.org/10.1016/j.jclinepi.2011.01.012

Handoll, H. H. G., Elliott, J., Thillemann, T. M., Aluko, P., & Brorson, S. (2022). Interventions for treating proximal humeral fractures in adults. Cochrane Database of Systematic Reviews, 2022(6). https://doi.org/10.1002/14651858.CD000434.pub5

Higgins, J. P., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003). Measuring inconsistency in meta-analyses. BMJ (Clinical research edition.), 327(7414), 557–560. https://doi.org/10.1136/bmj.327.7414.557

Higgins JPT, Green S, & Ben Van Den A. (2020). Cochrane Handbook for Systematic Reviews of Interventions (Vol. 15). International Coaching Psychology Review.

Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and Elaboration. Journal of Clinical Epidemiology, 62(10), e1–e34. https://doi.org/10.1016/j.jclinepi.2009.06.006

Lim, MA, Ridia, KGM, Pranata R. Epidemiological pattern of orthopaedic fracture during the COVID-19 pandemic: A systematic review and meta-analysis (2021). Journal of Clinical Orthopaedics & Trauma, 16,16-23. https://doi.org/10.1016/j.jcot.2020.12.028

Lv, H., Zhan, Q., Yin, Y., Zhu, Y., Wang, J., Hou, Z., Zhang, Y., & Chen, W. (2020). Epidemiologic characteristics of traumatic fractures during the outbreak of coronavirus disease 2019 (COVID-19) in China: A retrospective & comparative multi-center study. Injury, 51(8), 1698-1704. https://doi.org/10.1016/j.injury.2020.06.022

Magaziner, J., Hawkes, W., Hebel, J. R., Zimmerman, S. I., Fox, K. M., Dolan, M., Felsenthal, G., & Kenzora, J. (2000). Recovery from hip fracture in eight areas of function. Journal of Gerontology, 55(9), M498-M507. https://academic.oup.com/biomedgerontology/article/55/9/M498/2948037

Maher, C. G., Sherrington, C., Herbert, R. D., Moseley, A. M., & Elkins, M. (2003). Reliability of the PEDro scale for rating quality of randomized controlled trials. Physical Therapy, 83(8), 713–721. http://www.ncbi.nlm.nih.gov/pubmed/12882612

Mani, S., Sharma, S., Omar, B., Paungmali, A., & Joseph, L. (2017). Validity and reliability of Internet-based physiotherapy assessment for musculoskeletal disorders: A systematic review. Journal of Telemedicine and Telecare, 23(3), 379–391. https://doi.org/10.1177/1357633X16642369

Martini, J. D., Ferreira, G. E., & Xavier de Araujo, F. (2022). Pilates for neck pain: A systematic review and meta-analysis of randomised controlled trials. Journal of Bodywork and Movement Therapies, 31, 37–44. https://doi.org/10.1016/j.jbmt.2022.03.011

Özden, F., Sarı, Z., Karaman, Ö. N., & Aydoğmuş, H. (2022). The effect of video exercise-based telerehabilitation on clinical outcomes, expectation, satisfaction, and motivation in patients with chronic low back pain. Irish Journal of Medical Science, 191(3), 1229–1239. https://doi.org/10.1007/s11845-021-02727-8

Pech-Arguelles, R. C., Miranda-Ortiz, Y. J., Velázquez-Hernández, H. E., Domínguez-Cordero, R., Ruiz-Pacheco, C., Figueroa-García, J., & Rojano-Mejía, D. (2024). Tele-rehabilitation program in patients with distal radius fracture: a controlled clinical trial. Cirugía y Cirujanos (English Edition), 92(1). https://doi.org/10.24875/cirue.m22000599

Peretti, A., Amenta, F., Tayebati, S. K., Nittari, G., & Mahdi, S. S. (2017). Telerehabilitation: Review of the state-of-the-art and areas of application. JMIR Rehabilitation and Assistive Technologies, 4(2), e7. https://doi.org/10.2196/rehab.7511

Phang, J. K., Lim, Z. Y., Yee, W. Q., Tan, C. Y. F., Kwan, Y. H., & Low, L. L. (2023). Post-surgery interventions for hip fracture: A systematic review of randomized controlled trials. BMC Musculoskeletal Disorders, 24(1). https://doi.org/10.1186/s12891-023-06512-9

Pinto, R. Z., Maher, C. G., Ferreira, M. L., Hancock, M., Oliveira, V. C., McLachlan, A. J., Koes, B., & Ferreira, P. H. (2012). Epidural corticosteroid injections in the management of sciatica. Annals of Internal Medicine, 157(12), 865. https://doi.org/10.7326/0003-4819-157-12-201212180-00564

Piqueras, M., Marco, E., Coll, M., Escalada, F., Ballester, A., Cinca, C., Belmonte, R., & Muniesa, J. M. (2013). Effectiveness of an interactive virtual telerehabilitation system in patients after total knee arthroplasty: A randomized controlled trial. Journal of Rehabilitation Medicine, 45(4), 392–396. https://doi.org/10.2340/16501977-1119

Robinson, L. S., Sarkies, M., Brown, T., & O’Brien, L. (2016). Direct, indirect and intangible costs of acute hand and wrist injuries: A systematic review. Injury, 47(12), 2614–2626. https://doi.org/10.1016/j.injury.2016.09.041

Shea, B. J., Reeves, B. C., Wells, G., Thuku, M., Hamel, C., Moran, J., Moher, D., Tugwell, P., Welch, V., Kristjansson, E., & Henry, D. A. (2017). AMSTAR 2: A critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ (Online), 358. https://doi.org/10.1136/bmj.j4008

Shiwa, S. R., Costa, L. O. P., Costa, L. da C. M., Moseley, A., Hespanhol Junior, L. C., Venâncio, R., Ruggero, C., Sato, T. de O., & Lopes, A. D. (2011). Reproducibility of the Portuguese version of the PEDro Scale. Cadernos de Saúde Pública, 27(10), 2063–2068. https://doi.org/10.1590/S0102-311X2011001000019

Singer, B. R., McLauchlan, G. J., Robinson, C. M., & Christie, J. (1998). Epidemiology of fractures in 15 000 adults. Journal of Bone & Joint Surgery British Volume, 80-B(2), 243-248. https://doi.org/10.1302/0301-620X.80B2.0800243

Suero-Pineda, A., Oliva-Pascual-Vaca, Á., Durán, M. R. P., Sánchez-Laulhé, P. R., García-Frasquet, M. Á., & Blanquero, J. (2023). Effectiveness of a telerehabilitation evidence-based tablet app for rehabilitation in traumatic bone and soft tissue injuries of the hand, wrist, and fingers. Archives of Physical Medicine and Rehabilitation, 104(6), 932–941. https://doi.org/10.1016/j.apmr.2023.01.016

Wang, Q., Hunter, S., Lee, R. L.-T., & Chan, S. W.-C. (2023). The effectiveness of a mobile application-based programme for rehabilitation after total hip or knee arthroplasty: A randomised controlled trial. International Journal of Nursing Studies, 140, 104455. https://doi.org/10.1016/j.ijnurstu.2023.104455

Ye J, Li Q, Nie J (2022) Prevalence, characteristics, and associated risk factors of wrist fractures in Americans above 50: The cross-sectional NHANES study. Frontiers in Endocrinology, 13. https://doi.org/10.3389/fendo.2022.800129

Downloads

Published

2025-06-12

How to Cite

Grivicich da Silva, G., Xavier de Araújo, F., Andriola, A. H., Pereira, G. C., & Silva, M. F. (2025). Telerehabilitation on the Physical and Functional Capacity of Traumatic Fractures of the Upper Limbs: A Systematic Review with Meta-Analysis. International Journal of Telerehabilitation, 17(1). https://doi.org/10.63144/ijt.2025.6667

Issue

Vol. 17 No. 1 (2025)

Section

Clinical Research

License

Copyright (c) 2025 Guilherme Grivicich da Silva, Francisco Xavier de Araújo, André H. Andriola, Gustavo P. Costa, Marcelo Faria Silva

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.