Effect of Telerehabilitation in Parkinson Disease: A Systematic Review and Meta-Analysis.

IMPORTANCE

Rehabilitation is a key in managing Parkinson disease (PD), but access barriers remain, and the benefits of telerehabilitation (TR) are still unclear.

OBJECTIVE

The objective of this systematic review and meta-analysis was to examine the effect of TR in adults with PD through the International Classification of Functioning, Disability, and Health.

DATA SOURCES: An electronic database search (PubMed, EMBASE, SCOPUS, PEDro, Cochrane) was performed for data published from inception to April 2025.

DATA SELECTION: Inclusion criteria were randomized controlled trials involving adults with PD, assessing remotely delivered physical activity or physical rehabilitation interventions, compared to control groups not exposed to TR, and reporting outcomes of interest. Exclusion criteria included studies involving additional neurological disorders.

DATA EXTRACTION AND SYNTHESIS: Data extraction was guided by the PRISMA guidelines. This review was registered with PROSPERO (CRD42023475545). A risk of bias assessment (RoB-2) and methodological quality assessment (PEDro) tools were used. Data were analyzed using random-effects models.

MAIN OUTCOMES AND MEASURES: The outcomes of interest were balance, gait, functional mobility, physical activity, quality of life (QOL), and social support.

RESULTS

Eighteen studies were included in the final analysis, involving 731 individuals with PD. The most common types of TR included remote-based exergaming and using video conferencing platforms. The results indicated no statistically significant difference between TR and control groups on balance (standardized mean difference [SMD] = 0.31, 95% CI = -0.02 to 0.65), gait speed (SMD = -0.07, 95% CI = -0.33 to 0.19), and functional mobility (SMD = 0.05, 95% CI = -0.27 to 0.37) outcomes. However, the results were statistically in favor of TR for improving QOL (SMD = 0.26, 95% CI = 0.05 to 0.47).

CONCLUSIONS AND RELEVANCE: TR yielded similar or superior results compared to non-exposed control conditions across the 5 outcomes evaluated. Health care providers can decide which method of care delivery they prefer based on patients' preferences and resources.