Objective To investigate the effectiveness of videoconferencing exercise interventions for people with chronic diseases. Design Systematic review incorporating meta-analysis. Data sources PubMed, Cinahl, MEDLINE, Web of Science, Embase and Scopus. Eligibility criteria The current literature was searched following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Trials analysing participants with chronic disease undergoing aerobic and/or resistance exercise training over videoconferencing, with exercise capacity and/or quality of life outcomes were included. Meta-analyses were conducted for between-group comparisons of exercise capacity and quality of life. Risk of bias was analysed using the Downs and Black quality checklist and the certainty of evidence with Grading of Recommendations, Assessment, Development and Evaluation (GRADE). Results Thirty-two trials were included in this review, of which 12 were comparator trials. Small–moderate between-group (videoconferencing vs comparator) effects favouring videoconferencing were seen for studies using a non-exercising comparator for exercise capacity (standardised mean difference (SMD)=0.616, 95% CI 0.278 to 0.954; p=<0.001) and quality of life (SMD=0.400, 95% CI 0.099 to 0.701; p=0.009). Small effects favouring videoconferencing were observed for studies using an exercising comparator for quality of life (SMD=0.271, 95% CI 0.028 to 0.515; p=0.029) and exercise capacity (SMD=0.242, 95% CI 0.059 to 0.426; p=0.009). Moderate risk of bias was identified for included studies (16.3±3.6/28), with GRADE certainty ratings of ‘low’ (quality of life) and ‘moderate’ (exercise capacity). Session attendance was 70% and was reported in 23 trials. No serious adverse events relating to videoconferencing were found. Nine trials documented the total number of technical issues that occurred in 17% of the sessions. Positive satisfaction outcomes were associated with ease of access and usefulness of technology. Conclusion In patients with chronic disease, videoconferencing exercise interventions appear to be feasible and effective for improving exercise capacity and quality of life. More robust methodology is needed in future studies to improve the certainty of the evidence. PROSPERO registration number CRD42020191243.

中文翻译：

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通过远程医疗进行锻炼对慢性病的有效性：对通过视频会议提供的锻炼干预措施进行系统回顾和荟萃分析


目的探讨视频会议运动干预对慢性病患者的效果。设计结合荟萃分析的系统审查。数据来源 PubMed、Cinahl、MEDLINE、Web of Science、Embase 和 Scopus。资格标准 按照系统评价和荟萃分析指南的首选报告项目检索当前文献。其中包括分析慢性病参与者通过视频会议接受有氧运动和/或阻力运动训练的试验，以及运动能力和/或生活质量结果。对运动能力和生活质量进行组间比较进行荟萃分析。使用 Downs 和 Black 质量检查表以及建议、评估、开发和评估分级 (GRADE) 来分析证据的确定性，分析偏倚风险。结果 本次评价纳入 32 项试验，其中 12 项为对照试验。在使用非运动比较器评估运动能力的研究中，发现有利于视频会议的小-中度组间（视频会议与比较器）效应（标准化平均差 (SMD)=0.616，95% CI 0.278 至 0.954；p=<0.001），生活质量（SMD=0.400，95% CI 0.099 至 0.701；p=0.009）。使用运动比较器对生活质量（SMD=0.271，95% CI 0.028 至 0.515；p=0.029）和运动能力（SMD=0.242，95% CI 0.059 至 0.426；p=0.009）的研究观察到有利于视频会议的小影响）。纳入的研究存在中等偏倚风险 (16.3±3.6/28)，GRADE 确定性评级为“低”（生活质量）和“中等”（运动能力）。会议出席率为 70%，并在 23 项试验中进行了报告。 没有发现与视频会议相关的严重不良事件。九项试验记录了 17% 的会议中发生的技术问题总数。积极的满意度结果与技术的易用性和实用性相关。结论 对于慢性病患者，视频会议运动干预对于提高运动能力和生活质量似乎是可行且有效的。未来的研究需要更稳健的方法来提高证据的确定性。 PROSPERO 注册号 CRD42020191243。