Home-Based Physiotherapy for Older Adults: An EvidenceBased Review of Effectiveness, Functional Outcomes, and Health System Implications

This evidence-based review, supported by a systematic literature search, examines the scientific evidence on home-based physiotherapy for older adults, focusing on clinical effectiveness, functional impact, and implications for health systems. The analysis included 30 high-relevance studies published between 2016 and 2026, comprising randomized controlled trials, systematic reviews, and meta-analyses. The findings demonstrate that home-based physiotherapy programs, including telerehabilitation modalities, are effective in improving functional mobility, reducing falls, decreasing hospitalizations, and enhancing quality of life across diverse older populations. These populations include post-stroke patients, frail older adults, individuals with chronic obstructive pulmonary disease (COPD) and heart failure, as well as those undergoing post-surgical recovery. Evidence indicates that home-based physiotherapy interventions are cost-effective and can significantly reduce health service utilization, with estimated savings ranging from USD 123,500 to USD 1.6 million for every 100 older adults at high risk of falls. Telerehabilitation emerges as a particularly promising modality, demonstrating non-inferiority or superiority compared with traditional in-person rehabilitation, alongside high patient satisfaction and strong potential for scalability within health systems.