Evaluating the Feasibility and Effectiveness of Using a Smartphone Application During Rehabilitation in Patients After Total Knee Replacement

Singapore General Hospital30 enrolled

Overview

Despite best efforts to provide standardized and effective rehabilitation sessions post-total knee replacement (TKR), there are a few factors that may result in sub-optimal recovery in this group of patients. There is a need to develop innovative rehabilitation strategies that (i) provide patients with accurate cues allowing for better compliance and exercise performance, (ii) allow for therapists to ensure continuity of care, monitor compliance, and identify deviation from recovery trajectories post-discharge, prior to their first outpatient appointment, and (iii) reduce reliance on manpower and variability during rehabilitation sessions. Technological solutions that empower patients and allow home-based rehabilitation to take place without the need for real-time human supervision could be the key to improving effectiveness and lowering costs. A mobile application which detects key landmarks on the body for human pose estimation will allow patients to perform their rehabilitation exercises with real-time feedback allowing for proper execution of the exercises. Physiotherapists will be able to access the data generated from the exercise session via a command centre to monitor patients' recovery progress and compliance. The primary aim of this pilot study is to evaluate the feasibility of using a mobile application during rehabilitation in patients after a TKR surgery. The secondary aim is to study the effects of using a mobile application during rehabilitation on knee functional status, exercise self-efficacy, and treatment satisfaction after TKR surgery.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Interventions

Mobile applicationDEVICE

Participants will be instructed on the installation and use of the mobile application on their personal mobile phones. Participants will then have to perform the assigned exercises using the mobile application 3 times daily. Physiotherapists will still perform the required assessment/review, education, and intervention.

Standard rehabilitation programOTHER

All participants will be seen by physiotherapists in the ward post-TKR surgery and undergo standard inpatient rehabilitation. Patients will be given instructions to perform assigned exercises 3 times daily. Physiotherapists will perform the required assessment/review, education, and intervention.

Eligibility

Sex: ALLMin age: 45 YearsMax age: 100 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Primary unilateral total knee replacement 2. Age \>= 45 years 3. Under the Enhanced Recovery After Surgery (ERAS) programme (discharge on post-operative day 0/1) 4. Willingness to be randomized to either mobile application group or standard hospital-based rehabilitation group 5. Ability to provide informed consent 6. Is technologically savvy - at least 6 months' experience using a smartphone and able to key in data into a smartphone 7. English-speaking Exclusion Criteria: 1. Rheumatoid arthritis and other systemic arthritis 2. A previous history of stroke and other major neurological conditions 3. An intention to transfer to step-down care facilities post-operatively or intention to continue outpatient physiotherapy service at another institution 4. Unable to perform 5 repetitions of inner-range quadriceps exercise

Outcomes

Primary Outcomes

Compliance

Frequency of exercise sessions completed

Time frame: 6 weeks post-surgery