Effect of Home-based Telerehabilitation on Balance, Functional Mobility, and Quality of Life in Persons with Parkinson's Disease: A Systematic Review and Meta-Analysis

Background: Persons with Parkinson’s disease (PwPD) require ongoing rehabilitation to maintain independence, but traditional center-based and unsupervised home programs have limitations in accessibility and adherence. Home-based telerehabilitation (TR) offers a promising alternative by enabling remote delivery of exercise interventions. Objective: To evaluate the effect of home-based TR on balance, functional mobility, and quality of life in PwPD. Methods: A comprehensive electronic search was conducted across PubMed, CINAHL, Embase, OvidSP, ProQuest, Scopus, Web of Science, Cochrane CENTRAL, and PEDro databases. Interventional studies on exercise-centric home-based TR for PwPD with either balance, functional mobility, or quality of life as outcomes were included. Results: A total of 37 studies were included in this systematic review, of which 13 were eligible for meta-analysis. The meta-analysis revealed small but significant improvements in balance (SMD = 0.25; 95% CI: 0.04 to 0.45; p = 0.02). and functional mobility (SMD = -0.28; 95% CI: -0.52 to -0.05; p = 0.02). However, no significant effect was observed for quality of life (SMD = -0.08; 95% CI: -0.25 to 0.09; p = 0.35). Conclusion: Home-based TR is effective for improving balance and functional mobility in PwPD, although, its effect on quality of life is unclear which warrants further research.