EFFECTIVENESS OF TELEREHABILITATION FOR MUSCULOSKELETAL SPORT INJURIES: A SYSTEMATIC REVIEW AND META ANALYSIS
Abstract
Background: Musculoskeletal injuries are among the most common causes of physical disability in athletes, often requiring long-term rehabilitation. Advances in digital health technologies have allowed the uptake of telerehabilitation (TR) over in-person therapy. However, TR's effects in sports-related musculoskeletal injuries have been reported variably at a clinical level.
Objective: This systematic review and meta-analysis aim to explore the effectiveness of telerehabilitation compared to traditional rehabilitation in improving functional outcomes, pain relief, and satisfaction among patients with musculoskeletal injuries.
Methods: A systematic search of PubMed and related databases revealed 25 peer-reviewed studies published during the period of 2017 to 2025. Eligible studies comprised randomized controlled trials, systematic reviews, and meta-analyses evaluating TR interventions in sport-associated musculoskeletal disorders. Outcomes of interest included pain severity, functional recovery, patient compliance, and patient satisfaction.
Results: Most of the studies found that TR led to at least as much or better effects than traditional rehabilitation on pain and functioning outcomes. Meta-analytic search suggested that TR did not differ significantly from face-to-face interventions in the incidence of adverse events. Program duration, adherence rates, and technological access were, however, highlighted as key moderators of efficacy.
Conclusions: Telerehabilitation is a safe and effective solution to common musculoskeletal sports injury rehabilitation. Utilization of such a strategy will be limited by adherence to prescribed protocols, patient education, and usage of digital health in order to enhance clinical outcomes and engagement.
References
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
Seron, P., Oliveros, M. J., Gutierrez-Arias, R., Fuentes-Aspe, R., Torres-Castro, R. C., Merino-Osorio, C., Nahuelhual, P., Inostroza, J., Jalil, Y., Solano, R., Marzuca-Nassr, G. N., Aguilera-Eguía, R., Lavados-Romo, P., Soto-Rodríguez, F. J., Sabelle, C., Villarroel-Silva, G., Gomolán, P., Huaiquilaf, S., & Sanchez, P. (2021). Effectiveness of Telerehabilitation in Physical Therapy: A Rapid Overview. Physical therapy, 101(6), pzab053. https://doi.org/10.1093/ptj/pzab053
Grona, S. L., Bath, B., Busch, A., Rotter, T., Trask, C., & Harrison, E. (2018). Use of videoconferencing for physical therapy in people with musculoskeletal conditions: A systematic review. Journal of telemedicine and telecare, 24(5), 341–355. https://doi.org/10.1177/1357633X17700781
Buabbas, A. J., Albahrouh, S. E., Alrowayeh, H. N., & Alshawaf, H. (2022). Telerehabilitation during the COVID-19 Pandemic: Patients and Physical Therapists' Experiences. Medical principles and practice : international journal of the Kuwait University, Health Science Centre, 31(2), 156–164. https://doi.org/10.1159/000523775
Bargeri, S., Castellini, G., Vitale, J. A., Guida, S., Banfi, G., Gianola, S., & Pennestrì, F. (2024). Effectiveness of Telemedicine for Musculoskeletal Disorders: Umbrella Review. Journal of medical Internet research, 26, e50090. https://doi.org/10.2196/50090.
Vieira, L. M. S. M. A., de Andrade, M. A., & Sato, T. O. (2023). Telerehabilitation for musculoskeletal pain - An overview of systematic reviews. Digital health, 9, 20552076231164242. https://doi.org/10.1177/20552076231164242
Muñoz-Tomás, M. T., Burillo-Lafuente, M., Vicente-Parra, A., Sanz-Rubio, M. C., Suarez-Serrano, C., Marcén-Román, Y., & Franco-Sierra, M. Á. (2023). Telerehabilitation as a Therapeutic Exercise Tool versus Face-to-Face Physiotherapy: A Systematic Review. International Journal of Environmental Research and Public Health, 20(5), 4358. https://doi.org/10.3390/ijerph20054358
Lee, A. C., Deutsch, J. E., Holdsworth, L., Kaplan, S. L., Kosakowski, H., Latz, R., McNeary, L. L., O'Neil, J., Ronzio, O., Sanders, K., Sigmund-Gaines, M., Wiley, M., & Russell, T. (2024). Telerehabilitation in Physical Therapist Practice: A Clinical Practice Guideline From the American Physical Therapy Association. Physical therapy, 104(5), pzae045. https://doi.org/10.1093/ptj/pzae045
Morri, M., Ruisi, R., Culcasi, A., & Peccerillo, V. (2024). The Effectiveness of Telerehabilitation for Functional Recovery After Orthopedic Surgery: A Systematic Review and Meta-Analysis. Telemedicine reports, 5(1), 78–88. https://doi.org/10.1089/tmr.2023.0057
Lin, T. W., Yang, Y., Hong, H. Y., Zhou, X. B., Tung, T. H., Zheng, B. B., & Zhang, J. M. (2025). Effectiveness of telerehabilitation in non-operatively managed shoulder conditions: a systematic review and meta-analysis. BMC musculoskeletal disorders, 26(1), 614. https://doi.org/10.1186/s12891-025-08839-x
Lemersre, P., Vincent, R., & Zidarov, D. (2025). Exploration of Implementation and Uses of Telerehabilitation in Physical Therapy in France During the COVID-19 Pandemic. Musculoskeletal care, 23(3), e70170. https://doi.org/10.1002/msc.70170
Elsabbagh, L., AlQahtani, H., Alsultan, A. A., AlDossary, H. J., Alresheidi, H., Abdelhamid, A., & Buraik, D. W. (2024). Effect of telerehabilitation assessment for adults with musculoskeletal conditions on access to care beyond the COVID-19 pandemic: A retrospective case-control analysis. Digital health, 10, 20552076241288734. https://doi.org/10.1177/20552076241288734
Amin, J., Ahmad, B., Amin, S., Siddiqui, A. A., & Alam, M. K. (2022). Rehabilitation Professional and Patient Satisfaction with Telerehabilitation of Musculoskeletal Disorders: A Systematic Review. BioMed research international, 2022, 7366063. https://doi.org/10.1155/2022/7366063
Pratama, A. D., Farelin, A. D., Karnadipa, T., Pahlawi, R., Noviana, M., & Abdullah, F. (2022). The Application of Telerehabilitation for Pain Reduction and Improving Quality of Life in Workers with Work-Related Musculoskeletal Disorders: Systematic Review. Proceedings, 83(1), 45. https://doi.org/10.3390/proceedings2022083045
Wu, Y. Q., Long, Y., Peng, W. J., Gong, C., Liu, Y. Q., Peng, X. M., Zhong, Y. B., Luo, Y., & Wang, M. Y. (2023). The Efficacy and Safety of Telerehabilitation for Fibromyalgia: Systematic Review and Meta-analysis of Randomized Controlled Trials. Journal of medical Internet research, 25, e42090. https://doi.org/10.2196/42090
He, J., Xu, C., Huang, L., Wang, H., & Lu, S. (2025). Telerehabilitation versus face-to-face physical therapy for middle-aged patients with degenerative meniscal tear in China: a non-inferiority randomized controlled trial. Journal of rehabilitation medicine, 57, jrm43237. https://doi.org/10.2340/jrm.v57.43237
Mojica, E. S., Vasavada, K., Hurley, E. T., Lin, C. C., Buzin, S., Gonzalez-Lomas, G., Alaia, M. J., Strauss, E. J., Jazrawi, L. M., & Campbell, K. A. (2023). Despite Equivalent Clinical Outcomes, Patients Report Less Satisfaction With Telerehabilitation Versus Standard In-Office Rehabilitation After Arthroscopic Meniscectomy: A Randomized Controlled Trial. Arthroscopy, sports medicine, and rehabilitation, 5(2), e395–e401. https://doi.org/10.1016/j.asmr.2023.01.006.
Stamou, M., Nikolaou, C., & Chοiras, S. (2024). Telerehabilitation in Physiotherapy Science: A Scoping Review. Cureus, 16(2), e54396. https://doi.org/10.7759/cureus.54396
Huang, T., Zhang, W., Yan, B., Liu, H., & Girard, O. (2024). Comparing Telerehabilitation and Home-based Exercise for Shoulder Disorders: A Systematic Review and Meta-analysis. Archives of physical medicine and rehabilitation, 105(11), 2214–2223. https://doi.org/10.1016/j.apmr.2024.02.723.
van Egmond, M. A., van der Schaaf, M., Vredeveld, T., Vollenbroek-Hutten, M. M. R., van Berge Henegouwen, M. I., Klinkenbijl, J. H. G., & Engelbert, R. H. H. (2018). Effectiveness of physiotherapy with telerehabilitation in surgical patients: a systematic review and meta-analysis. Physiotherapy, 104(3), 277–298. https://doi.org/10.1016/j.physio.2018.04.004
Havran, M. A., & Bidelspach, D. E. (2021). Virtual Physical Therapy and Telerehabilitation. Physical medicine and rehabilitation clinics of North America, 32(2), 419–428. https://doi.org/10.1016/j.pmr.2020.12.005.
Pak, S. S., Janela, D., Freitas, N., Costa, F., Moulder, R., Molinos, M., Areias, A. C., Bento, V., Cohen, S. P., Yanamadala, V., Souza, R. B., & Correia, F. D. (2023). Comparing Digital to Conventional Physical Therapy for Chronic Shoulder Pain: Randomized Controlled Trial. Journal of medical Internet research, 25, e49236. https://doi.org/10.2196/49236
Turolla, A., Rossettini, G., Viceconti, A., Palese, A., & Geri, T. (2020). Musculoskeletal Physical Therapy During the COVID-19 Pandemic: Is Telerehabilitation the Answer?. Physical therapy, 100(8), 1260–1264. https://doi.org/10.1093/ptj/pzaa093.
Lee, A. C., Davenport, T. E., & Randall, K. (2018). Telehealth Physical Therapy in Musculoskeletal Practice. The Journal of orthopaedic and sports physical therapy, 48(10), 736–739. https://doi.org/10.2519/jospt.2018.0613.
Janela, D., Costa, F., Weiss, B., Areias, A. C., Molinos, M., Scheer, J. K., Lains, J., Bento, V., Cohen, S. P., Correia, F. D., & Yanamadala, V. (2023). Effectiveness of biofeedback-assisted asynchronous telerehabilitation in musculoskeletal care: A systematic review. Digital health, 9, 20552076231176696. https://doi.org/10.1177/20552076231176696.
Copyright (c) 2025 Bartosz Golis, Anna Maria Gęsińska, Krystian Czyżykowski, Helena Szelka, Paweł Edyko, Alicja Babula, Wiktor Golus, Katarzyna Andrzejewska, Zuzanna Przybyła, Hubert Woźniak
This work is licensed under a Creative Commons Attribution 4.0 International License.
All articles are published in open-access and licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). Hence, authors retain copyright to the content of the articles.
CC BY 4.0 License allows content to be copied, adapted, displayed, distributed, re-published or otherwise re-used for any purpose including for adaptation and commercial use provided the content is attributed.
