Physical Medicine

Home rehabilitation modestly improves BADL and physical performance in older adults

This systematic review and meta-analysis of 27 RCTs (n=4,948) found activity-based interventions improved basic ADLs (SMD 0.29, moderate evidence). Exercise-based interventions improved BADL and physical performance (SMD 0.43 for some outcomes). IADL benefits were not demonstrated and reablement-style programs showed inconsistent effects. Apply mainly to community-dwelling adults aged ≥65 with low physical performance or ADL difficulties. 1

Telerehabilitation often ranks highly for pain and disability in chronic nonspecific low back pain

This Bayesian network meta-analysis included 20 RCTs (n=1,854) comparing telerehab, in-person rehab, and usual care for chronic nonspecific low back pain. Telerehabilitation ranked best for pain at 8–12 weeks (SUCRA 87.2% at 12 weeks; moderate-certainty evidence). In-person rehab tended to rank higher early (4 weeks) for some disability measures and for kinesiophobia, but certainty was generally low. Health-related quality-of-life physical scores improved with telerehab (mean difference 6.05, moderate-certainty evidence). 2

Pulmonary rehabilitation outcome reporting in older adults is highly heterogeneous

This systematic review of 95 studies (n=204,626) identified 590 outcome indicators consolidated into 148 unique outcome types across six domains. Geriatric-specific measures such as balance, frailty, and physical activity ability were infrequently reported. Adverse events and mortality were underrepresented in outcome reporting. Authors recommend developing a geriatric-focused core outcome set to improve consistency and personalization of PR. 3