Abstract
Rehabilitation is essential in postoperative recovery after surgery on the upper extremities. Still, findings on the effectiveness of specific exercise and physical rehabilitation interventions are inconsistent across studies. This systematic review and meta-analysis aimed to determine the effects of postoperative physical activities and rehabilitation interventions on pain management, functional outcomes, and quality of life following upper extremity operations. A literature search was conducted in PubMed, Scopus, and Web of Science through June 2023. Postoperative exercise, physical rehabilitation interventions, or studies that were clinical and evaluated the interventions were included. Nine randomized controlled trials and 18 other clinical cases were assessed using random-effects models, and the mean differences were pooled. These findings showed that physical exercise and rehabilitation were effective in improving postoperative outcomes. The reduction of functional disability (as a measure using Disabilities of the Arm, Shoulder, and Hand (DASH) score) was 28.2 (95% CI: -41.1 to -15.3; p = 0.001). The pain intensity was reduced by 1.65 points (95% CI: -1.99 - 1.32; p = 0.001), and quality-of-life scores were enhanced by 0.84 points (95% CI: 0.35 - 1.33). Intermediate and high heterogeneity was found in the outcomes (I2 = 4390%), indicating differences in rehabilitation protocols and design. The findings concluded that postoperative exercise and physical rehabilitation are effective in reducing pain and disability, promoting functional recovery, and improving quality of life following upper extremity surgery.

Key words: Upper extremity surgery, rehabilitation, physical therapy, exercise, postoperative recovery, meta-analysis.

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