Analysis of the application effect of new rehabilitation nursing methods in orthopedic postoperative rehabilitation: A systematic review and meta-analysis of randomized controlled trials.
Fan Cao, Lingyun Shi, Xiao Wang
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In 30 seconds
This systematic review and meta-analysis pooled randomised controlled trials of technology-enabled rehabilitation nursing versus usual postoperative care after lower-limb arthroplasty. Fifteen trials included 1,012 participants receiving the intervention and 954 controls, predominantly after total knee arthroplasty. Overall, technology-enabled care was associated with a small improvement in patient-reported function (Hedges g = 0.28; 95% CI 0.00 to 0.56; p = 0.049), with substantial heterogeneity (I² = 86%). Evidence certainty was rated moderate; subgroup differences by technology type were not statistically significant.
Key findings
- Across 15 RCTs, technology-enabled rehabilitation improved patient-reported function modestly (g = 0.28; 95% CI 0.00 to 0.56; p = 0.049; I² = 86%).
- Virtual reality had the largest point estimate (g = 0.62; 95% CI -0.18 to 1.41; 4 trials), but its confidence interval included no effect.
- Web/app telerehabilitation (g = 0.18; 95% CI -0.24 to 0.59; 8 trials) and robot/sensor interventions (g = 0.14; 95% CI -0.23 to 0.50; 3 trials) showed non-significant benefits.
- Differences between technology subgroups were not significant (χ² test p = 0.16); certainty of evidence was rated moderate.
Why it matters
Patient-reported function is an important outcome after lower-limb arthroplasty, and these pooled results suggest technology-enabled programmes may offer a modest benefit compared with usual care. However, substantial variation across trials and the absence of significant differences between technology classes mean that the apparent promise of any one modality remains uncertain. The findings support further evaluation of programme components and resource implications.
What to keep in mind
The pooled estimate had substantial heterogeneity (I² = 86%), and the evidence base was weighted toward total knee arthroplasty, with only three THA trials and one mixed-procedure trial. Technology subgroup estimates were imprecise.