## 1 Background  
The elbow is an anatomically complex joint prone to complications and functional impairments following trauma [1]. Complications may include limitation in range of motion (ROM), nerve injury, pain, joint instability, formation of heterotopic ossification, and joint stiffness [2]. Limitation to the functionality of the elbow may affect everyday activities [3, 4]. It is estimated that a 50% decrease in elbow function may lead to an 80% reduction of daily activities [5]. Rehabilitation following elbow injury is complex and poses challenges for both the patient and the therapist [6]. It was shown that prolonged immobility following elbow injury is a major factor in limiting joint ROM [7]. Most evidence-based literature supports early joint activation in order to restore limb function [1, 8] In the topic of elbow rehabilitation after fractures and dislocations, there are few reports of the efficacy of active interventions, and most of the protocols are based on clinical experience [1, 4, 9, 10].  
Tele-rehabilitation is a tool that enables clinicians to perform evaluation and treatment of the patient using communication technologies. Studies show that tele-rehabilitation is effective for recovery of motor function following stroke or traumatic brain injuries [11; 12; 13]. Unfortunately, studies investigating the efficacy of tele-rehabilitation following orthopedic injuries are scarce [14; 15]. Moreover, within the literature concerning tele-rehabilitation of orthopedic injuries, most concern lower limb injuries. A recent review surveying gaming and tele-rehabilitation for treating orthopedic injuries [16] showed that the great majority of tele-rehabilitation studies included lower limb orthopedics patients. While advanced technologies for allowing monitored elbow tele-rehabilitation emerge [17; 18], literature investigating the value of tele-rehabilitation following elbow injuries is lacking. To the best of our knowledge, while tele-rehabilitation was shown to be a valid and reliable tool for assessment of elbow disorders [19], no previous studies investigated the effect of tele-rehabilitation following elbow fractures. It was suggested that some of the advantages of tele-rehabilitation are that it reduces health care costs, improves treatment adherence, and is delivered in a manner that is satisfactory to the patients [20; 21; 22]. However, evidence-based trials quantifying the integration of computerized devices in tele-rehabilitation for motor rehabilitation are lacking. The COVID-19 pandemic that resulted in government regulation of social distancing has increased the need for solutions for remote healthcare [23; 24].  
Considering all of the above, the aim of this study was to compare quantitative objective and subjective measures of rehabilitation following elbow fracture, between a group who received conventional treatment and a group who received a combination of tele-rehabilitation via a biofeedback device and conventional treatment. The two groups received one month of intervention immediately post-surgery and were evaluated at four time points: immediately after the surgery, 1 month post-surgery, 3 months post-surgery, and one year post-surgery. Both follow-up trials performed, 3 months and 1 year post-surgery, were conducted in order to detect postintervention effects, conveying information about the long-term benefits recorded in each group.