The effectiveness of digital applications providing personalized exercise videos: a systematic review with meta-analysis (Preprint)

BACKGROUND Among available digital applications (Apps), those providing personalized video exercises (PEV) may be helpful for individuals undergoing functional rehabilitation. OBJECTIVE We aimed to assess the effectiveness of Apps providing PEV to support rehabilitation for people with disability, on functional capacity, confidence in exercise performance, use of care, health-related quality of life, adherence, and adverse events. METHODS In this systematic review, we searched MEDLINE, CENTRAL and EMBASE databases up to March 2022. All randomized controlled trials evaluating the effect of Apps providing PEV to support rehabilitation for any condition requiring physical rehabilitation were included. Selection, extraction and risk of bias assessment (RoB2) were performed by two independent reviewers. Primary outcome was functional capacity at the end of the intervention. Secondary outcomes included confidence in exercise performance, care consumption, health-related quality of life, adherence, and adverse events. A meta-analysis was performed where possible; the magnitude of the effect was assessed with the standardized mean difference (SMD). RESULTS From 1641 identified references, 10 articles (1050 participants, 93% adults) were included: 7 articles (906 participants) concerned musculoskeletal disorders; 3 (144 participants) concerned neurological disorders, and 2 (332 participants) were employee-based. The Apps were mostly commercial (7/10); the videos were mostly elaborated by a physiotherapist (8/10). Duration of App use was 3-48 weeks. All included studies had a high overall risk of bias. Low-quality evidence suggested the use of Apps providing PEV led to a significant, small to moderate improvement in physical function (SMD 0.35 [95% CI 0.19 to 0.51], Phet=0.86; I²=0%) and confidence in exercise performance (SMD 0.67 [0.37 to 0.96], phet=0.22; I²=33%). Because of the very low quality of the evidence, the effects on quality of life and exercise adherence were uncertain. Apps did not influence rate of adverse events. CONCLUSIONS Apps providing PEV to support exercise performance significantly improved physical function and confidence in exercise performance. However, the level of evidence was low: more robust studies are needed to confirm these results. CLINICALTRIAL PROSPERO: CRD42022323670