Effectiveness of telerehabilitation on upper limb functionality in women after breast cancer treatment: A systematic review of randomized clinical trials
In brief
Telerehabilitation shows no clear advantage over usual care for arm recovery in 883 post-mastectomy women
A systematic review of eleven randomized trials (883 participants) found that remote rehab programs did not significantly improve functional disability, muscle strength, or shoulder range of motion compared with standard therapies, except in isolated studies using highly interactive motion-capture feedback. Evidence is low to moderate certainty, highlighting the need for larger, well-designed non-inferiority trials.
- Journal
- Journal of telemedicine and telecare (Q1)
- Published
- 23 July 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Taynara Louisi Pilger, Franklin Fernandes Pimentel, Francisco José Candido Dos Reis
- PMID
- 42489535
- DOI
- 10.1177/1357633X261469958
Why clinicians should know about it
- Picked for Health Informatics (top studies of the week, 26 July 2026).
Abstract
IntroductionTo systematically evaluate the effectiveness of telerehabilitation on upper limb functional disability, muscle strength, and range of motion among women treated for breast cancer.MethodsPubMed, CINAHL, Web of Science, and EMBASE were searched for articles published up to April 2026. Randomized controlled trials evaluating telerehabilitation interventions for upper limb dysfunction following breast cancer treatment were included. Two reviewers independently performed data extraction and risk of bias assessment using the Cochrane RoB 2 tool. Certainty of evidence was appraised using the GRADE approach.ResultsEleven randomized controlled trials (N = 883) were included. Telerehabilitation delivery was heterogeneous, including asynchronous apps, multidimensional platforms, and telephone support. For functional disability (eight studies, n = 672), most trials reported within-group improvements, but between-group differences were generally non-significant (low certainty evidence). For muscle strength (five studies, n = 321) and shoulder range of motion (three studies, n = 239), gains were comparable to control groups (moderate certainty evidence). The superiority of telerehabilitation was only observed in isolated trials utilizing highly interactive systems (e.g. motion-capture feedback) compared to passive controls.ConclusionTelerehabilitation shows potential as a feasible and promising modality to support post-breast cancer upper limb recovery, particularly when incorporating interactive technologies. However, its definitive clinical equivalence or superiority remains unproven, primarily because remote modalities are frequently compared against clinically active controls, and the current body of evidence is limited by high intervention heterogeneity. Future research requires well-powered non-inferiority trials and clearly defined control arms to isolate the specific effects of remote technological delivery.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.