Effects of Tele Rehabilitation vs Onsite Rehabilitation on Balance, Mobility, and Risk of Fall Among Geriatric Population With Knee Osteoarthritis

Knee osteoarthritis is a prevalent degenerative joint disorder among the geriatric population and is associated with pain, reduced functional mobility, impaired balance, and an increased risk of falls. These impairments often reduce independence and quality of life in older adults. Conventional onsite physiotherapy is widely recommended for managing knee osteoarthritis; however, many elderly individuals encounter barriers to receiving regular treatment due to transportation problems, limited access to rehabilitation facilities, and physical restrictions. Telerehabilitation provides an alternative model of care by delivering rehabilitation services remotely through telecommunication technology and may improve accessibility and continuity of care. � FINAL SYNOPSIS FURQAN KHAN.docx The objective of this study is to determine the effects of telerehabilitation versus onsite rehabilitation on balance, mobility, and risk of fall among geriatric patients with knee osteoarthritis. The study will use a single-blinded randomized controlled trial design. A total sample of 44 participants aged 65 years or older with diagnosed knee osteoarthritis will be recruited according to the predefined inclusion and exclusion criteria. Participants will be randomly allocated into two groups by coin toss: a telerehabilitation group and an onsite rehabilitation group. � FINAL SYNOPSIS FURQAN KHAN.docx Both groups will receive the same rehabilitation program consisting of balance training and mobility exercises. The intervention will be performed four days per week for six weeks, with approximately 30-minute sessions, resulting in 24 treatment sessions. Balance training will progress through static balance, dynamic balance, sensory integration with visual integration, and reactive balance exercises. Mobility exercises will include heel raises, sit-to-stand activities, and step-up/step-down exercises. Participants in the telerehabilitation group will perform the exercises at home under remote supervision using a smartphone, while participants in the onsite rehabilitation group will receive the same program in the clinic. A caregiver will be required to remain present during tele-rehabilitation sessions to ensure participant safety. � FINAL SYNOPSIS FURQAN KHAN.docx Outcome assessments will be conducted at baseline (week 0), week 3, and week 6 using the Berg Balance Scale to evaluate balance, the Timed Up and Go (TUG) Test to assess mobility, and a Fall Risk Assessment Tool to evaluate the risk of falls. Data will be analyzed using SPSS version 20. Normality of the data will be assessed using the Shapiro-Wilk test. Ethical approval will be obtained from the Ethical Committee of Ibadat International University Islamabad. Written informed consent will be obtained from all participants before enrollment, and participant confidentiality and privacy will be maintained throughout the study.

Inclusion criteria

• Age ≥65 years. History of fall (within one month). Timed Up and Go (TUG) test score >14 seconds. Older adult having a smartphone. Older adult having at least Matric education. Berg Balance Scale score between 21 and 40. Osteoarthritis affecting one or both knees (already diagnosed)

Exclusion criteria

• Vision loss. Spinal pathology (monoplegia, hemiplegia, quadriplegia). Cognitive impairments. Neurological impairment. Physical handicap (loss of vision or loss of one limb).