Digital-Based and Telerehabilitation Interventions in Orthopaedic Postoperative Recovery: Literature Review

Authors

DOI:

https://doi.org/10.37287/ijghr.v8i2.320

Keywords:

digital rehabilitation, intervention, orthopedic patients, postoperative, telerehabilitation

Abstract

Orthopedic surgery aims to treat musculoskeletal disorders; however, postoperative recovery often presents functional limitations. Digital interventions and telerehabilitation are increasingly being applied in nursing, although evidence of their effectiveness remains limited. This systematic review evaluated the effectiveness of these technologies in supporting postoperative orthopedic recovery and identified their contributions to evidence-based nursing practice. A systematic review following the PRISMA guidelines was conducted using Scopus, PubMed, Web of Science, ScienceDirect, and SAGE databases. Randomized controlled trials and quasi-experimental studies published between 2015 and 2025 involving adult postoperative orthopedic patients were included. The interventions were compared with conventional rehabilitation. Six outcome domains were evaluated: physical function, quality of life, pain, psychosocial aspects, self-efficacy, patient compliance and satisfaction. A total of 1,508 articles were identified, of which 16 studies met the inclusion criteria. Digital-based interventions and telerehabilitation consistently improved physical function (e.g., Timed Up and Go, Functional Independence Measure), increased quality of life (EQ-5D, SF-36), and reduced postoperative pain more rapidly than conventional rehabilitation did. Improvements were also observed in anxiety, depression, self-efficacy, health literacy, patient satisfaction, and adherence to the rehabilitation program. Digital and telerehabilitation interventions effectively support orthopedic postoperative recovery, positively affecting physical, psychosocial, and behavioral outcomes. A multimodal model integrating education, exercise, occupational therapy, and psychosocial support based on self-efficacy and biopsychosocial approaches yielded optimal results. Integration into surgical nursing practice is recommended, with attention to technological infrastructure and clinician training.

References

Amanda, Y. N. (2024). Case Report: The Role of Physiotherapy in Cases of Postoperative Knee Stiffness Corresponding Author. Journal of Multidisciplinary Research of the Nation, 1(6). https://ejournal.amirulbangunbangsapublishing.com/index.php/jpnmb/index

Anderson, A. M. (2022). Development of a pre-operative education and prehabilitation digital intervention for patients awaiting total knee replacement: a Virtual Knee School (Issue June).

Bandura, A. (1978). Self-efficacy: Toward a unifying theory of behavioral change. Advances in Behaviour Research and Therapy, 1(4), 139–161. https://doi.org/10.1016/0146-6402(78)90002-4

Bandura, A. (1994). Self-Efficacy. In Encyclopedia of Human Behavior (Vol. 4, Issue 1994). Academic Press.

Bolan, N., Cowgill, K. D., Walker, K., Kak, L., Shaver, T., Moxon, S., & Lincetto, O. (2021). Human resources for health-related challenges to ensuring quality newborn care in low- And middle-income countries: A scoping review. Global Health Science and Practice, 9(1), 160–176. https://doi.org/10.9745/GHSP-D-20-00362

Braz, J., Solorzano, C., Wang, X., & Basbaum, A. (2014). Transmitting Pain and Itch Messages: A Contemporary View of the Spinal Cord Circuits that Generate Gate Control. Neuron, 82(3), 522–536. https://doi.org/10.1016/j.neuron.2014.01.018

Brazeiro, M. de C., Mueller, K. F., Rohde, C. da S., Lopes, B. de M., & Silva, M. F. (2025). Face-to-face exercises are not superior to telerehabilitation in recent post-operative total hip arthroplasty: a randomized clinical trial. Acta Ortopedica Brasileira, 33(Spe), e278202. https://doi.org/10.1590/1413-785220243201e278202

Cutilli, C. C. (2020). Excellence in Patient Education: Evidence-Based Education that "Sticks" and Improves Patient Outcomes. Nursing Clinics of North America, 55(2), 267–282. https://doi.org/10.1016/j.cnur.2020.02.007

Deci, E. L., & Ryan, R. M. (2015). Self-Determination Theory. In International Encyclopedia of the Social & Behavioral Sciences: Second Edition. https://doi.org/10.1016/B978-0-08-097086-8.26036-4

Donohoe, E., Roberts, H. J., Miclau, T., & Kreder, H. (2020). Management of Lower Extremity Fractures in the Elderly: A Focus on Post-Operative Rehabilitation. Injury, 51, S118–S122. https://doi.org/10.1016/j.injury.2020.04.050

Eichler, S., Salzwedel, A., Rabe, S., Mueller, S., Mayer, F., Wochatz, M., Hadzic, M., John, M., Wegscheider, K., & Völler, H. (2019). The Effectiveness of Telerehabilitation as a Supplement to Rehabilitation in Patients After Total Knee or Hip Replacement: Randomized Controlled Trial. JMIR Rehabilitation and Assistive Technologies, 6(2), e14236. https://doi.org/10.2196/14236

Fascio, E., Vitale, J. A., Sirtori, P., Peretti, G., Banfi, G., & Mangiavini, L. (2022). Early Virtual-Reality-Based Home Rehabilitation after Total Hip Arthroplasty: A Randomized Controlled Trial. Journal of Clinical Medicine, 11(7). https://doi.org/10.3390/JCM11071766

Gilboa, Y., Maeir, T., Karni, S., Eisenberg, M. E., Liebergall, M., Schwartz, I., & Kaufman, Y. (2019). Effectiveness of a tele-rehabilitation intervention to improve performance and reduce morbidity for people post hip fracture - Study protocol for a randomized controlled trial. BMC Geriatrics, 19(1), 1–9. https://doi.org/10.1186/S12877-019-1141-Z/FIGURES/1

Haddaway, N. R., Page, M. J., Pritchard, C. C., & McGuinness, L. A. (2022). PRISMA2020: An R package and Shiny app for producing PRISMA 2020-compliant flow diagrams, with interactivity for optimised digital transparency and Open Synthesis. Campbell Systematic Reviews, 18(2), e1230. https://doi.org/https://doi.org/10.1002/cl2.1230

Hagger, M. S., Hankonen, N., Chatzisarantis, N. L. D., & Ryan, R. M. (2020). Changing Behavior Using Self-Determination Theory. In The Handbook of Behavior Change. https://doi.org/10.1017/9781108677318.008

Jensen, C. M., Overgaard, S., Wiil, U. K., & Clemensen, J. (2019). Can Tele-Health Support Self-Care and Empowerment? A qualitative study of hip fracture patients' experiences with testing an "app." SAGE Open Nursing, 5. https://doi.org/10.1177/2377960819825752

Kwok, C. H. T., & Trang, T. (2024). Anatomy and Physiology of Pain. In Managing Pain in Children and Young People: A Clinical Guide, Third Edition. https://doi.org/10.1002/9781119645641.ch3

Li, C. T. L., Hung, G. K. N., Fong, K. N. K., Gonzalez, P. C., Wah, S. H., & Tsang, H. W. H. (2022). Effects of home-based occupational therapy telerehabilitation via smartphone for outpatients after hip fracture surgery: A feasibility randomised controlled study. Journal of Telemedicine and Telecare, 28(4), 239–247. https://doi.org/10.1177/1357633X20932434

Lim, J. Y., Yu, H. J., Kim, S. H., Lee, J. I., Lim, J. Y., Wang, J. H., & Hwang, J. H. (2024). Effectiveness of In-Home, Augmented Reality–Based Telerehabilitation After Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial. Orthopaedic Journal of Sports Medicine, 12(10), 23259671241271730. https://doi.org/10.1177/23259671241271729

Made, I., Budhiasa, D., Serengga, A., Gede, L., Darmawan, W. R., Isdaryanti, L., Lestari, D. P., Nurhidayah, K. F., & Bakar, A. (2025). Effectiveness of Continuous Nursing Care on Quality of Life and Management of Complications in Patients with Ostomy Surgery: A Systematic Review. Indonesian Journal of Global Health Research, 7(3), 449–464. https://doi.org/10.37287/IJGHR.V7I3.6153

Mahapatra, A., & Sharma, P. (2024). Biopsychosocial Approach to Mental Health. In Mental Health Care Resource Book: Concepts and Praxis for Social Workers and Mental Health Professionals. https://doi.org/10.1007/978-981-97-1203-8_5

Makivić, I., & Klemenc-Ketiš, Z. (2022). Development and validation of the scale for measuring biopsychosocial approach of family physicians to their patients. Family Medicine and Community Health, 10(2). https://doi.org/10.1136/fmch-2021-001407

Marina, N. S. A. P. M., Serengga, I. M. D. B. A., Lestari, D. P., Nurhidayah, K. F., & Dewi, Y. S. (2025). The Role of Nursing Intervention in Postoperative Pain Management: A Scoping Review. Indonesian Journal of Global Health Research, 7(3), 213–226. https://doi.org/10.37287/IJGHR.V7I3.5591

Marzola, P., Melzer, T., Pavesi, E., Gil-Mohapel, J., & Brocardo, P. S. (2023). Exploring the Role of Neuroplasticity in Development, Aging, and Neurodegeneration. Brain Sciences, 13(12). https://doi.org/10.3390/brainsci13121610

Mora-Traverso, M., Molina-Garcia, P., Prieto-Moreno, R., Borges-Cosic, M., Cruz Guisado, V., del Pino Algarrada, R., Moreno-Ramírez, P., Gomez-Jurado, G., Gomez Tarrias, C., Hidalgo Isla, M., Jiménez Andrés, P., Linares Gago, M., Lirola-Liebanas, A., Mesa-Ruiz, A., Muñoz-Garach, A., Salazar-Graván, S., Estevez-Lopez, F., Martín-Matillas, M., & Ariza-Vega, P. (2022). An m-Health telerehabilitation and health education program on physical performance in patients with hip fracture and their family caregivers: Study protocol for the ActiveHip+ randomized controlled trial. Research in Nursing & Health, 45(3), 287–299. https://doi.org/10.1002/NUR.22218

Mora-Traverso, M., Prieto-Moreno, R., Molina-Garcia, P., Salas-Fariña, Z., Martín-Martín, L., Martín-Matillas, M., & Ariza-Vega, P. (2024). Effects of the @ctivehip telerehabilitation program on the quality of life, psychological factors and fitness level of patients with hip fracture. Journal of Telemedicine and Telecare, 30(3), 549–558. https://doi.org/10.1177/1357633X211073256

Nelson, M., Bourke, M., Crossley, K., & Russell, T. (2020). Telerehabilitation is non-inferior to usual care following total hip replacement — a randomized controlled non-inferiority trial. Physiotherapy (United Kingdom), 107, 19–27. https://doi.org/10.1016/j.physio.2019.06.006

Nurjanah, S., Mulyana, A. M., Arhustia, H. D., Ayuningsih, R., Fazriyyah, Y. F., Rahayu, U., Pebrianti, S., & Arifin, H. (2023). Pain management in postoperative bone fracture patients: A systematic scoping review. The Journal of Palembang Nursing Studies, 2(2), 126–133. https://doi.org/10.55048/jpns23

Ortiz-Piña, M., Molina-Garcia, P., Femia, P., Ashe, M. C., Martín-Martín, L., Salazar-Graván, S., Salas-Fariña, Z., Prieto-Moreno, R., Castellote-Caballero, Y., Estevez-Lopez, F., & Ariza-Vega, P. (2021). Effects of Tele-Rehabilitation Compared with Home-Based in-Person Rehabilitation for Older Adult's Function after Hip Fracture. International Journal of Environmental Research and Public Health 2021, Vol. 18, Page 5493, 18(10), 5493. https://doi.org/10.3390/IJERPH18105493

Pimenta, S., Hansen, H., Demeyer, H., Slevin, P., & Cruz, J. (2023). Role of digital health in pulmonary rehabilitation and beyond: shaping the future. ERJ Open Research, 9(2), 1–18. https://doi.org/10.1183/23120541.00212-2022

Poljaković, Z. (2019). Impact of physical activity on neuroplasticity and neurorehabilitation after stroke | Utjecaj tjelesne aktivnosti na neuroplastičnost možga i neurorehabilitaciju nakon moždanog air. Medicus, 28(2), 205–211.

Ramdhani, M. Z., Nugraha, B. A., & Rahayu, U. (2024). POSTOPERATIVE MANAGEMENT IN OPEN FRACTURE SEGMENTAL CRURIS: CASE REPORT. Journal of Scientific Research, 3(6).

Savarimalai, R., Jagannathan, A., John, S., Reddy, S. K., & Pandian, D. (2021). Biopsychosocial Approach for Improving the Quality Life of Persons with Mental Illness: A Case Report from India. Journal of Psychosocial Rehabilitation and Mental Health, 8(1), 81–87. https://doi.org/10.1007/s40737-020-00210-8

Skou, S. T., Poulsen, E., Bricca, A., Dideriksen, M., Lohmander, L. S., Roos, E. M., & Juhl, C. B. (2022). Benefits and Harms of Interventions With Surgery Compared to Interventions Without Surgery for Musculoskeletal Conditions: A Systematic Review With Meta-analysis. Journal of Orthopaedic and Sports Physical Therapy, 52(6), 312–344. https://doi.org/10.2519/jospt.2022.11075

Strukov, R. N., Koneva, E. S., Khaptagaev, T. B., Pesotskaya, A. A., Konev, S. M., Aganesov, A. G., Aleksanyan, M. M., & Zhumanova, E. N. (2022). [Effectiveness of physical therapy after total hip arthroplasty at the third stage of rehabilitation using a telemedicine program]. Voprosy Kurortologii, Fizioterapii, i Lechebnoi Fizicheskoi Kultury, 99(4. Vyp. 2), 37–42. https://doi.org/10.17116/KURORT20229904237

Suharyono, Dewi, Y. S., & Pratiwi, I. N. (2021). The Effect of Virtual Reality-Based Rehabilitation in Reducing Pain Intensity in Postoperative Orthopedic Surgery Patients: A Systematic Review. Forikes Journal of Voice Health Research. https://doi.org/10.33846/sf12405

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

WHO. (2024). Fragility fractures. World Health Organization.

Zamroni, A. H. (2022). Nursing Care for Cruris Fracture Clients with Acute Pain Nursing Problems. Faculty of Nursing, Universitas Airlangga.

Zhang, D., Ding, H., Shen, C., Liu, Y., & Jia, N. (2025). Evaluating the role of nursing interventions in enhanced recovery after surgery for minimally invasive spine surgery: a retrospective analysis. Frontiers in Surgery, 12(February), 1–10. https://doi.org/10.3389/fsurg.2025.1519135

Zhang, Y. Y., Zhang, Y. G., Li, Z., Li, S. H., & Xu, W. G. (2022). Effect of Home-based Telerehabilitation on the Postoperative Rehabilitation Outcome of Hip Fracture in the Aging Population. Orthopaedic Surgery, 14(8), 1768–1777. https://doi.org/10.1111/OS.13293

Zheng, Y., & Yan, Q. (2023). Effect of application of short-form video health education on the health knowledge and satisfaction with nursing care of patients with lower extremity fractures. BMC Nursing, 22(1), 395. https://doi.org/10.1186/s12912-023-01530-3.

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Published

2026-04-25

How to Cite

Tabik, A. D., Zamroni, A. H., Abidah, A., Serengga, I. M. D. B. A., Dorman, J. E. B., Nurhidayah, K. F., … Hendra Kurnia Rakhma. (2026). Digital-Based and Telerehabilitation Interventions in Orthopaedic Postoperative Recovery: Literature Review. Indonesian Journal of Global Health Research, 8(2), 955–966. https://doi.org/10.37287/ijghr.v8i2.320

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