The Effect of Sensor-Based Rehabilitation (SR) on Chronic Knee Pain (CKP) Outcomes-A Systematic Review and Meta-Analysis (SRMA).

Introduction: This study aims to evaluate the effect of sensor-based rehabilitation (SR) on chronic knee pain (CKP) outcomes.

Materials and methods: PubMed, Embase, CINAHL, SCOPUS, Cochrane Library, grey literature, and bibliographic references were searched from inception to April 2023. Only randomized controlled trials (RCTs) and cohort studies evaluating the outcomes of SR on CKP were included. Inclusion and exclusion criteria were based on type of study, research subjects, intervention, outcome, language, and availability of data. Out of 937 studies screened, a total of 10 studies with 4347 patients met selection criteria. Comparison of outcomes following intervention was conducted across studies. Meta-analysis of KOOS subscales was also conducted. Literature retrieval and data extraction were conducted by three independent reviewers. Two reviewers performed quantitative data extraction independently before compilation and cross-referencing on Covidence with a third researcher assisting in the cross-referencing process independently to minimise judgment errors.

Results: The sensors utilized included wearable sensors, plantar-controlled sensors, embedded sensors, and optical sensors. There was a high degree of variability in the conduct of the intervention programs and timepoint of assessment. There was an improvement in the KOOS aggregate scores from baseline to post intervention with better improvements seen in studies incorporating avatar-based biofeedback. However, meta-analysis of the KOOS subscales did not show clinically significant differences between control and intervention groups.

Conclusion: There is insufficient evidence to support the routine use of SR in patients with CKP. However, there is some evidence to suggest that incorporation of SR with avatar-based biofeedback in a multi-faceted treatment approach may yield better outcomes than the use of sensors as merely activity trackers.