{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T10:38:24Z","timestamp":1792579104786,"version":"4.5.0"},"reference-count":45,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Rehabil Assist Technol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec sec-type=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Digital technologies have become common in postoperative orthopedic rehabilitation. The tendency toward this adoption appeared in the past decade. However, no standard method exists to classify their functional capabilities. This absence hinders practical implementation. Clinicians currently lack a structured framework to distinguish between the functional capabilities of different digital rehabilitation technologies effectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"objective\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This scoping review aims to map digital interventions used in postsurgical orthopedic rehabilitation to a proposed Coordination, Alignment, Motivation, and Strength (CAMS) framework and to identify research trends, functional coverage, and gaps in current evidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search was conducted across 5 databases: MEDLINE (via PubMed), Scopus, IEEE Xplore, Cochrane Central Register of Controlled Trials (CENTRAL), and the Physiotherapy Evidence Database (PEDro), following PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Studies were mapped to the proposed CAMS framework pillars. Multiple validated appraisal tools were applied descriptively according to study design: version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2; n=32), the Newcastle-Ottawa Scale (NOS) for observational studies (n=2), and the Methodological Index for Non-Randomized Studies (MINORS) for nonrandomized designs (n=1).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 35 studies met the inclusion criteria. Coordination was the most frequently addressed pillar (29\/35, 83%), followed by Motivation (26\/35, 74%). Alignment was addressed in 37% (13\/35) of studies, while Strength was the least represented pillar (12\/35, 34%). Overall, 49% (17\/35) of studies were rated \u201clow risk\u201d overall on the primary appraisal tool, 46% (16\/35) demonstrated \u201csome concerns,\u201d and 6% (2\/35) were rated \u201chigh risk,\u201d with performance bias identified as a consistent methodological characteristic across the corpus. Delivery models were predominantly hybrid (14\/35, 40%) or home-based (13\/35, 37%), with 8 studies (8\/35, 23%) using an exclusively clinical model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Digital health has shown a notable increase in the kinematic monitoring feature, offering effective solutions to movement quality (Coordination and Alignment) and psychological engagement (Motivation). Nevertheless, there is a consistent gap in strength-related studies, as current decentralized tools lack the capability to quantify physiological load. The next phase of innovations should be a shift to integrated 4-pillar solutions that would coordinate resistance-based training with high-precision biomechanical monitoring. The CAMS framework is proposed as an exploratory classification tool to guide future research design and technology evaluation in postsurgical digital rehabilitation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/100548","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T08:15:07Z","timestamp":1786436107000},"page":"e100548-e100548","source":"Crossref","is-referenced-by-count":0,"title":["Digital Technologies in Postsurgical Orthopedic Rehabilitation: Scoping Review Mapping Interventions to the CAMS Framework (2020\u20102025)"],"prefix":"10.2196","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6806-8034","authenticated-orcid":false,"given":"Ngan Kuen","family":"Lai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5121-124X","authenticated-orcid":false,"given":"Hai","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9703-7043","authenticated-orcid":false,"given":"Tet Khuan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3973-3917","authenticated-orcid":false,"given":"Muhammad Nur Affendy","family":"Nor'a","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3643-7518","authenticated-orcid":false,"given":"Jeffery","family":"Sijore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0247-6668","authenticated-orcid":false,"given":"Wei Yang","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1299-8179","authenticated-orcid":false,"given":"YongSheng","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,10,20]]},"reference":[{"issue":"2","key":"R1","doi-asserted-by":"publisher","first-page":"101","DOI":"10.2106\/JBJS.19.00695","article-title":"Effects of virtual exercise rehabilitation in-home therapy compared with traditional care after total knee arthroplasty: VERITAS, a randomized controlled trial","volume":"102","author":"Prvu Bettger","journal-title":"J Bone Joint Surg Am"},{"issue":"1","key":"R2","doi-asserted-by":"publisher","DOI":"10.1002\/msc.70041","article-title":"Effectiveness of virtual reality for pain management in musculoskeletal disorders across anatomical regions: a systematic review and meta-analysis","volume":"23","author":"Zitti","journal-title":"Musculoskeletal Care"},{"issue":"10","key":"R3","doi-asserted-by":"publisher","DOI":"10.1177\/23259671241271729","article-title":"Effectiveness of in-home, augmented reality-based telerehabilitation after anterior cruciate ligament reconstruction: a randomized controlled trial","volume":"12","author":"Lim","journal-title":"Orthop J Sports Med"},{"issue":"4","key":"R4","doi-asserted-by":"publisher","first-page":"44","DOI":"10.15758\/ajk.2025.27.4.44","article-title":"Emerging role of visual biofeedback in rehabilitation following ACL reconstruction","volume":"27","author":"Kim","journal-title":"Asian J Kinesiol"},{"key":"R5","doi-asserted-by":"publisher","DOI":"10.3389\/fbioe.2023.1335251","article-title":"Effective evaluation of HGcnMLP method for markerless 3D pose estimation of musculoskeletal diseases patients based on smartphone monocular video","volume":"11","author":"Hu","journal-title":"Front Bioeng Biotechnol"},{"issue":"2","key":"R6","doi-asserted-by":"publisher","DOI":"10.3390\/s24020554","article-title":"Wearable sensor to monitor quality of upper limb task practice for stroke survivors at home","volume":"24","author":"Seo","journal-title":"Sensors (Basel)"},{"issue":"5","key":"R7","doi-asserted-by":"publisher","first-page":"658","DOI":"10.1080\/17483107.2021.1906960","article-title":"Robotic assistive and rehabilitation devices leading to motor recovery in upper limb: a systematic review","volume":"18","author":"Khalid","journal-title":"Disabil Rehabil Assist Technol"},{"key":"R8","doi-asserted-by":"publisher","DOI":"10.3389\/frobt.2025.1531067","article-title":"Rehabilitation robotics and allied digital technologies: opportunities, barriers and solutions for improving their clinical implementation. A position paper from the Fit for Medical Robotics Initiative","volume":"12","author":"Aprile","journal-title":"Front Robot AI"},{"issue":"7","key":"R9","doi-asserted-by":"publisher","first-page":"467","DOI":"10.7326\/M18-0850","article-title":"PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation","volume":"169","author":"Tricco","journal-title":"Ann Intern Med"},{"issue":"1","key":"R10","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-025-06187-z","article-title":"Impact of cloud-based follow-up exercise prescription on knee function and quality of life in homebound patients post-total knee arthroplasty: a randomized controlled trial","volume":"20","author":"Chen","journal-title":"J Orthop Surg Res"},{"issue":"1","key":"R11","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-025-06230-y","article-title":"Feasibility and efficacy of real-time teleresistance exercise programs for physical function in elderly patients after hip fracture surgery: a randomized controlled trial","volume":"25","author":"Dajpratham","journal-title":"BMC Geriatr"},{"issue":"3","key":"R12","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1053\/j.sart.2025.04.009","article-title":"Physical therapy following shoulder arthroplasty: an assessment of telerehabilitation vs. in-person physical therapy","volume":"35","author":"O\u2019Reilly","journal-title":"Semin Arthroplasty JSES"},{"key":"R13","doi-asserted-by":"publisher","DOI":"10.2196\/64643","article-title":"Effect of lifestyle modification through web-based telerehabilitation monitoring combined with supervised sensorimotor training after total knee arthroplasty: randomized controlled trial","volume":"13","author":"Sadiq","journal-title":"JMIR Mhealth Uhealth"},{"issue":"1","key":"R14","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-025-06403-w","article-title":"The efficacy and cost-effectiveness analysis of telerehabilitation for patients after arthroscopic ACL-reconstruction: a non-inferiority randomized controlled trial","volume":"20","author":"Yuan","journal-title":"J Orthop Surg Res"},{"key":"R15","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2024.1536579","article-title":"Mobile-based in-home telerehabilitation compared with in-hospital face-to-face rehabilitation for elderly patients after total hip arthroplasty in China\u2019s level 1 trauma center: a noninferiority randomized controlled trial","volume":"11","author":"Zhou","journal-title":"Front Surg"},{"issue":"10","key":"R16","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/pzae088","article-title":"Optimizing total knee arthroplasty rehabilitation with telehealth physical activity behavior change intervention: a randomized clinical trial","volume":"104","author":"Christiansen","journal-title":"Phys Ther"},{"issue":"1","key":"R17","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-024-04982-8","article-title":"Clinical application research of intelligent monitoring system for knee rehabilitation: a randomized controlled trial","volume":"19","author":"Xie","journal-title":"J Orthop Surg Res"},{"issue":"3","key":"R18","doi-asserted-by":"publisher","first-page":"575","DOI":"10.1016\/j.arth.2023.08.019","article-title":"A smartphone application-based remote rehabilitation system for post-total knee arthroplasty rehabilitation: a randomized controlled trial","volume":"39","author":"Zhao","journal-title":"J Arthroplasty"},{"issue":"15","key":"R19","doi-asserted-by":"publisher","first-page":"1500","DOI":"10.3390\/healthcare12151500","article-title":"A study on the effectiveness of VR rehabilitation training content for older individuals with total knee replacement: pilot study","volume":"12","author":"Shin","journal-title":"Health Care (Don Mills)"},{"key":"R20","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.1042167","article-title":"Mobile health-based home rehabilitation education improving early outcomes after anterior cruciate ligament reconstruction: a randomized controlled clinical trial","volume":"10","author":"Guo","journal-title":"Front Public Health"},{"issue":"9","key":"R21","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.33172","article-title":"Combined digital interventions for pain reduction in patients undergoing knee replacement: a randomized clinical trial","volume":"6","author":"Duong","journal-title":"JAMA Netw Open"},{"issue":"2","key":"R22","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pdig.0000175","article-title":"Sensor-based telerehabilitation system increases patient adherence after knee surgery","volume":"2","author":"H\u00f6her","journal-title":"PLOS Digit Health"},{"issue":"5","key":"R23","doi-asserted-by":"publisher","DOI":"10.3390\/jpm13050824","article-title":"Digital rehabilitation after knee arthroplasty: a multi-center prospective longitudinal cohort study","volume":"13","author":"Lebleu","journal-title":"J Pers Med"},{"issue":"1","key":"R24","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-023-06270-8","article-title":"The effect of a digital-assisted group rehabilitation on clinical and functional outcomes after total hip and knee arthroplasty-a prospective randomized controlled pilot study","volume":"24","author":"Osterloh","journal-title":"BMC Musculoskelet Disord"},{"issue":"1","key":"R25","doi-asserted-by":"publisher","DOI":"10.1038\/s41746-023-00842-7","article-title":"A randomized controlled trial of postoperative rehabilitation using digital healthcare system after rotator cuff repair","volume":"6","author":"Shim","journal-title":"NPJ Digit Med"},{"issue":"10","key":"R26","doi-asserted-by":"publisher","first-page":"6361","DOI":"10.1007\/s00402-023-04894-y","article-title":"Postoperative rehabilitation using a digital healthcare system in patients with total knee arthroplasty: a randomized controlled trial","volume":"143","author":"Shim","journal-title":"Arch Orthop Trauma Surg"},{"key":"R27","doi-asserted-by":"publisher","DOI":"10.1016\/j.asmart.2023.09.002","article-title":"Comparison between the effect of immersive virtual reality training versus conventional rehabilitation on limb loading and functional outcomes in patients after anterior cruciate ligament reconstruction: a prospective randomized controlled trial","volume":"34","author":"Gsangaya","journal-title":"Asia Pac J Sports Med Arthrosc Rehabil Technol"},{"key":"R28","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2023.09.012","article-title":"The effect of virtual reality on pain, kinesiophobia and function in total knee arthroplasty patients: a randomized controlled trial","volume":"45","author":"G\u00fcr","journal-title":"Knee"},{"issue":"12","key":"R29","doi-asserted-by":"publisher","first-page":"2629","DOI":"10.1080\/09638288.2023.2228689","article-title":"Telerehabilitation following fast-track total knee arthroplasty is effective and safe: a randomized controlled trial with the ReHub\u00ae platform","volume":"46","author":"Nuevo","journal-title":"Disabil Rehabil"},{"issue":"2","key":"R30","doi-asserted-by":"publisher","first-page":"e395","DOI":"10.1016\/j.asmr.2023.01.006","article-title":"Despite equivalent clinical outcomes, patients report Less satisfaction with telerehabilitation versus standard in-office rehabilitation after arthroscopic meniscectomy: a randomized controlled trial","volume":"5","author":"Mojica","journal-title":"Arthrosc Sports Med Rehabil"},{"issue":"9","key":"R31","doi-asserted-by":"publisher","DOI":"10.2196\/40703","article-title":"Postoperative outcomes of a digital rehabilitation program after Total knee arthroplasty: retrospective, observational feasibility study","volume":"6","author":"Hong","journal-title":"JMIR Form Res"},{"issue":"1","key":"R32","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1016\/j.jse.2021.08.019","article-title":"A multicenter randomized controlled trial comparing gamification with remote monitoring against standard rehabilitation for patients after arthroscopic shoulder surgery","volume":"31","author":"Marley","journal-title":"J Shoulder Elbow Surg"},{"issue":"6","key":"R33","doi-asserted-by":"publisher","first-page":"101609","DOI":"10.1016\/j.rehab.2021.101609","article-title":"Effect of balance training using virtual reality-based serious games in individuals with total knee replacement: a randomized controlled trial","volume":"65","author":"Pournajaf","journal-title":"Ann Phys Rehabil Med"},{"key":"R34","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctcp.2022.101687","article-title":"The influence of early virtual reality intervention on pain, anxiety, and function following primary total knee arthroplasty","volume":"49","author":"Fuchs","journal-title":"Complement Ther Clin Pract"},{"issue":"5","key":"R35","doi-asserted-by":"publisher","first-page":"660","DOI":"10.1177\/02692155221080546","article-title":"Effectiveness of adding virtual reality to physiotherapeutic treatment in patients with total hip arthroplasty. A randomized controlled trial","volume":"36","author":"Zavala-Gonz\u00e1lez","journal-title":"Clin Rehabil"},{"issue":"7","key":"R36","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11071766","article-title":"Early virtual-reality-based home rehabilitation after total hip arthroplasty: a randomized controlled trial","volume":"11","author":"Fascio","journal-title":"J Clin Med"},{"issue":"2","key":"R37","doi-asserted-by":"publisher","first-page":"139","DOI":"10.28982\/josam.1035076","article-title":"The effect of telerehabilitation on early outcomes in patients undergoing primary total knee replacement: a prospective randomized study","volume":"6","author":"\u015eahi\u0307n","journal-title":"J Surg Med"},{"issue":"2","key":"R38","doi-asserted-by":"publisher","DOI":"10.1136\/bmjsem-2020-001002","article-title":"Feasibility randomised controlled trial comparing TRAK-ACL digital rehabilitation intervention plus treatment as usual versus treatment as usual for patients following anterior cruciate ligament reconstruction","volume":"7","author":"Dunphy","journal-title":"BMJ Open Sport Exerc Med"},{"issue":"1","key":"R39","doi-asserted-by":"publisher","DOI":"10.2196\/14139","article-title":"Effectiveness of a home-based rehabilitation program after total hip arthroplasty driven by a tablet app and remote coaching: nonrandomized controlled trial combining a single-arm intervention cohort with historical controls","volume":"7","author":"Wijnen","journal-title":"JMIR Rehabil Assist Technol"},{"issue":"21","key":"R40","doi-asserted-by":"publisher","DOI":"10.3390\/s20216118","article-title":"A portable system for remote rehabilitation following a total knee replacement: a pilot randomized controlled clinical study","volume":"20","author":"Bell","journal-title":"Sensors (Basel)"},{"issue":"7","key":"R41","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000019136","article-title":"Effects of early virtual reality-based rehabilitation in patients with total knee arthroplasty: a randomized controlled trial","volume":"99","author":"Gianola","journal-title":"Medicine (Baltimore)"},{"key":"R42","doi-asserted-by":"publisher","DOI":"10.1016\/j.physio.2019.06.006","article-title":"Telerehabilitation is non-inferior to usual care following total hip replacement - a randomized controlled non-inferiority trial","volume":"107","author":"Nelson","journal-title":"Physiotherapy"},{"issue":"6","key":"R43","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1016\/0895-4356(90)90158-l","article-title":"High agreement but low kappa: I. The problems of two paradoxes","volume":"43","author":"Feinstein","journal-title":"J Clin Epidemiol"},{"key":"R44","doi-asserted-by":"publisher","DOI":"10.1177\/20552076241256861","article-title":"Effectiveness of digital home rehabilitation and supervision for stroke survivors: a systematic review and meta-analysis","volume":"10","author":"Hestetun-Mandrup","journal-title":"Digit Health"},{"issue":"1","key":"R45","doi-asserted-by":"publisher","DOI":"10.1038\/s41746-024-00998-w","article-title":"Artificial intelligence-driven virtual rehabilitation for people living in the community: a scoping review","volume":"7","author":"Abedi","journal-title":"NPJ Digit Med"}],"container-title":["JMIR Rehabilitation and Assistive Technologies"],"original-title":[],"language":"en","deposited":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T09:42:26Z","timestamp":1792575746000},"score":1,"resource":{"primary":{"URL":"https:\/\/rehab.jmir.org\/2026\/1\/e100548"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,20]]},"references-count":45,"URL":"https:\/\/doi.org\/10.2196\/100548","relation":{},"ISSN":["2369-2529"],"issn-type":[{"value":"2369-2529","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,20]]},"article-number":"v13i2e100548"}}