Table 2

Studies on the value of remote care in non-inflammatory RMDs (PICO 1)

StudyStudy designDiseaseDemographics*InterventionControlOutcomesResults†RoB‡
Amorim et al27RCTChronic back pain68Age: 58 y
Female: 50%
FU duration: 6 mo
Physical activity plan,
phone calls,
activity Tracker,
web application,
additionally to information booklet
Information bookletEfficacy
(pain, physical activity)
No differencesRoB 2: some concern
Azma et al28RCTKnee OA54Age: 56 y
Female: 60%
FU duration: 6 mo
Pamphlet with physical exercises,
logbook for physical activity,
monitoring phone calls
Office-based physical therapy for 6 weeksEfficacy
(pain; WOMAC)
No differencesRoB 2: high
Bennell et al29RCTKnee OA168Age: 62 y
Female: 16%
FU duration: 12 mo
Six telephone coaching sessions (education, physical activity, exercises and adherence strategies)PhysiotherapyEfficacy
(pain; WOMAC; PASE)
Better adherence, function, pain and/or physical activityRoB 2: some concern
Cuperus et al30RCTOA147Age: 60 y
Female: 85%
FU duration: 52 w
Two F2F meetings (patient education, pain management, physical activity),
four telephone calls (goal setting, progress reporting)
Six F2F meetingsEfficacy
(SF-36 pain; physical activity, GSES)
Worse pain, better physical activity. No difference in QoL and self-efficacyRoB 2: low
Cuperus et al41RCTOA147Age: 60 y
Female: 85%
FU duration: 52 w
Two F2F meetings (patient education, pain management, physical activity),
four telephone calls (goal setting, progress)
Six F2F meetingsCost-effectivenessWorse for quality-adjusted life years, lower total programme costsRoB 2: high
Friesen et al31RCTFM60Age: 48 y
Female: 95%
FU duration: 8 w
Eight-week long online programme on pain managementWaiting listEfficacy
User perception
Better for symptoms, depression, pain, fear of pain, generalised anxiety and physical health outcomes. No difference in patient satisfactionRoB 2: low
Geragthy el al32RCTLow back pain87Age: 58 y
Female: 61%
FU duration: 3 mo
Six-week web application use for self-management,
phone calls for support and encouragement,
additionally to usual care
Usual care (consultations and/or physiotherapy and/or pain clinics)Efficacy (RMDQ; pain)
Only descriptive analysis, no comparisons performedRoB 2: some concern
Hinman et al33RCTKnee OA175Age: 63 y
Female: 55%
FU duration: 12 mo
Telephone calls (physical activity),
additionally to help line (OA education)
Help line (OA education: self-management, community resources, emotional support and treatment escalations)Efficacy
(pain; WOMAC)
User perception
Better physical function, pain, physical activity and satisfaction outcomesRoB 2: low
Kloek et al40RCTKnee and/or hip OA208Age: 63 y
Female: 68%
FU duration: 12 mo
Five F2F physical therapy sessions,
web application (behavioural graded activities, exercises, disease education, progress reports)
Physical therapyEfficacy (TUG; accelerometer)
User perception
No difference in physical function. Slightly less sedentary behaviour. No difference in user perceptionRoB 2: high
Kloek et al42RCTKnee and/or hip OA208Age: 63 y
Female: 68%
FU duration: 12 mo
Five F2F physical therapy sessions,
web application (behavioural graded activities, exercises, disease education, progress reports)
Physical therapyCost-effectivenessNo differencesRoB 2: high
O’Brien et al34RCTOverweight patients with knee OA120Age: 62 y
Female: 62%
FU duration: 26 w
Telephone-based weight management and healthy lifestyle serviceWaiting list for orthopaedic consultationEfficay (pain; WOMAC, FABQ, SF-12)
(adverse events)
No difference in pain or physical function. Better fear avoidance and QoL. No difference in adverse eventsRoB 2: low
Odole and Ojo39RCTKnee OA50Age: 56 y
Female: 49%
FU duration: 6 w
Home exercises, telephone monitoring and coachingClinical-based therapyEfficacy
(WHOQo- Bref)
Better results on physical and psychological health according to WHO QoLRoB 2: high
Rutledge et al35RCTLow back pain62Age: 63 y
Female: 9%
FU duration: 8 w
Cognitive behavioural therapy via 1 F2F and 11 phone callsNurse delivered, telehealth supportive psychotherapyEfficacy
(pain, BDI-2)
User perception
No differences in pain, depression or patient satisfaction outcomesRoB 2: high
Shebib et al36RCTLow back pain177Age: 43 y
Female: 41%
FU duration: 12 w
Web application (education articles, cognitive behavioural therapy, team discussions, activity/symptom tracking, coaching, exercises)Receiving three digital education articlesEfficacy (pain)Better pain, impact on daily life and disability outcomesRoB 2: high
Skrepnik et al37RCTKnee OA211Age: 63 y
Female: 50%
FU duration: 3 mo
Mobile application (motivational messages, goal setting)
Additionally to F2F FU, wearable activity monitor and brochures on the benefit of walking
F2F FU, wearable activity tracker and brochures on the benefit of walkingEfficacy
(pain; N° of steps)
Safety (adverse events)
User perception
More steps per day and less pain. No difference in adverse events. No difference between physician/patient satisfaction reportedRoB 2: high
Solomon et al44RCTOsteoporosis879Age: 80 y
Female: 93%
FU duration: 12 mo
Telephone calls to improve medication adherence
Additionally to mailed educational materials
Mailed educational materialsAdherenceNo differencesRoB 2: high
Tso et al 43RCTOsteoporosis with fracture6591Age: 80 y
Female: 100%
FU duration: 4–5 mo
Telephone call (education on osteoporosis treatment)
Additionally to at baseline educational material sent via mail/fax
At baseline educational material sent via mail/faxAdherenceBetter for receiving appropriate osteoporosis treatmentRoB2: high
Vallejo et al38RCTFM60Age: 56 y
Female: 100%
FU duration: 12 mo
Web application (cognitive behavioural therapy, exercises), possibility to send questions to a therapistWaiting list or cognitive behavioural therapyEfficacy
Worse impact on daily functioning and better self-efficacy compared with the normal cognitive behavioural groupRoB2: high
Nero et al25Cohort studyOA25Age: 62 y
Female: 68%
FU duration: 3 mo
Six-week long web programme (education, exercises, physiotherapy)Twelve-week F2F programme (exercises, self-management techniques)Efficacy
Numerically higher pain reduction, (higher baseline pain in intervention group)ROBINS-I: low
Peterson et al26Cohort studyLow back pain47Age: 49 y
Female: 70%
FU duration: 1 day
Telerehabilitation assessment and assignment to treatment groups (mobilisation/manipulation, specific exercises, stabilisation)F2F assignment to the treatment groups by another physical therapistEfficacy (diagnostic accuracy)No differencesROBINS-I: moderate
  • *Age/Female ratio was calculated by the sum of age (mean or median) or female ratio (%) of intervention and control groups, respectively and divided by the number of groups, unless reported otherwise.

  • †Results are reported in respect to the comparison of the intervention with the control.

  • ‡Overall RoB is reported according to the RoB 2 tool (low, some concern, high RoB) and the ROBINS-I tool (low, moderate, serious RoB).

  • BDI-2, Beck Depression Inventory 2; BPI, Brief Pain Inventory; CPSS, Chronic Pain Self-efficacy Scale; FABQ, fear avoidance beliefs questionnaire; F2F, face-to-face; FIQR, Fibromyalgia Impact Questionnaire; FM, fibromyalgia; FU, follow-up; GSES, General Self-Efficacy Scale; HADS, Hospital Anxiety and Depression Scale; HAQ-DI, Health Assessment Questionnaire-Disability Index; mo, months; OA, osteoarthritis; PASE, physical activity scale for the elderly; QoL, quality of life; RCT, randomised controlled trial; RMDQ, Roland and Morris Disability Questionnaire; RMDs, rheumatic and musculoskeletal diseases; RoB, risk of bias; SF-12, Short Form 12; SF-36, Short Form 36; TUG, Timed Up & Go test; w, weeks; WHOQo-Bref, WHO Quality of life-Bref.