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Medium-Term Outcomes of Digital Versus Conventional Home-Based Rehabilitation After Total Knee Arthroplasty: Prospective, Parallel-Group Feasibility Study
Physical rehabilitation is recommended after total knee arthroplasty (TKA). With the expected increase in TKA over the next few decades, it is important to find new ways of delivering cost-effective interventions. Technological interventions have been developed with this intent, but only preliminary...
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| Published in: | JMIR rehabilitation and assistive technologies 2019-02, Vol.6 (1), p.e13111-e13111 |
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| creator | Correia, Fernando Dias Nogueira, André Magalhães, Ivo Guimarães, Joana Moreira, Maria Barradas, Isabel Molinos, Maria Teixeira, Laetitia Tulha, José Seabra, Rosmaninho Lains, Jorge Bento, Virgílio |
| description | Physical rehabilitation is recommended after total knee arthroplasty (TKA). With the expected increase in TKA over the next few decades, it is important to find new ways of delivering cost-effective interventions. Technological interventions have been developed with this intent, but only preliminary evidence exists regarding their validity, with short follow-up times.
This study aimed to present the follow-up results of a feasibility study comparing two different home-based programs after TKA: conventional face-to-face sessions and a digital intervention performed through the use of an artificial intelligence-powered biofeedback system under remote clinical monitoring.
The digital intervention uses a motion tracker allowing 3D movement quantification, a mobile app and a Web portal. This study presents the results of the previous single-center, prospective, parallel-group, feasibility study including an 8-week active treatment stage and further assessments at 3 and 6 months post-TKA. Primary outcome was the Timed Up and Go score, and secondary outcomes were the Knee Osteoarthritis Outcome Scale (KOOS) score and knee range of motion.
A total of 59 patients completed the study (30 in the digital intervention group and 29 in the conventional rehabilitation group) and follow-up assessments. During the active treatment stage, patients in the digital intervention group demonstrated high engagement and satisfaction levels, with an 82% retention rate. Both groups attained clinically relevant improvements from baseline to 6 months post-TKA. At the end of the 8-week program, clinical outcomes were superior in the digital intervention group. At the 3- and 6-month assessments, the outcomes remained superior for the Timed Up and Go score (P |
| doi_str_mv | 10.2196/13111 |
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This study aimed to present the follow-up results of a feasibility study comparing two different home-based programs after TKA: conventional face-to-face sessions and a digital intervention performed through the use of an artificial intelligence-powered biofeedback system under remote clinical monitoring.
The digital intervention uses a motion tracker allowing 3D movement quantification, a mobile app and a Web portal. This study presents the results of the previous single-center, prospective, parallel-group, feasibility study including an 8-week active treatment stage and further assessments at 3 and 6 months post-TKA. Primary outcome was the Timed Up and Go score, and secondary outcomes were the Knee Osteoarthritis Outcome Scale (KOOS) score and knee range of motion.
A total of 59 patients completed the study (30 in the digital intervention group and 29 in the conventional rehabilitation group) and follow-up assessments. During the active treatment stage, patients in the digital intervention group demonstrated high engagement and satisfaction levels, with an 82% retention rate. Both groups attained clinically relevant improvements from baseline to 6 months post-TKA. At the end of the 8-week program, clinical outcomes were superior in the digital intervention group. At the 3- and 6-month assessments, the outcomes remained superior for the Timed Up and Go score (P<.001) and all KOOS subscale scores (at 3 months, P<.001 overall; at 6 months, KOOS Symptoms: P=.006, Pain: P=.002, Activities of Daily Living: P=.001, Sports: P=.003, and Quality of Life: P=.001). There was progressive convergence between both groups in terms of the knee range of motion, which remained higher for standing flexion in the digital intervention group than the conventional group at 6 months (P=.01). For the primary outcome, at 6 months, the median difference between groups was 4.87 seconds (95% CI 1.85-7.47), in favor of the digital intervention group.
The present study demonstrates that this novel digital intervention for independent home-based rehabilitation after TKA is feasible, engaging, and capable of maximizing clinical outcomes in comparison to conventional rehabilitation in the short and medium term; in addition, this intervention is far less demanding in terms of human resources.
ClinicalTrials.gov NCT03047252; https://clinicaltrials.gov/ct2/show/NCT03047252.</description><identifier>ISSN: 2369-2529</identifier><identifier>EISSN: 2369-2529</identifier><identifier>DOI: 10.2196/13111</identifier><identifier>PMID: 30816849</identifier><language>eng</language><publisher>Canada: JMIR Publications</publisher><subject>Activities of daily living ; Arthritis ; Artificial intelligence ; Biofeedback ; Caregivers ; Costs ; Feasibility studies ; Hospitals ; Joint replacement surgery ; Joint surgery ; Knee ; Medicare ; Original Paper ; Osteoarthritis ; Patients ; Physical therapists ; Physical therapy ; Rehabilitation ; Surgical outcomes ; Telemedicine</subject><ispartof>JMIR rehabilitation and assistive technologies, 2019-02, Vol.6 (1), p.e13111-e13111</ispartof><rights>Fernando Dias Correia, André Nogueira, Ivo Magalhães, Joana Guimarães, Maria Moreira, Isabel Barradas, Maria Molinos, Laetitia Teixeira, José Tulha, Rosmaninho Seabra, Jorge Lains, Virgílio Bento. Originally published in JMIR Rehabilitation and Assistive Technology (http://rehab.jmir.org), 28.02.2019.</rights><rights>2019. This work is licensed under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Fernando Dias Correia, André Nogueira, Ivo Magalhães, Joana Guimarães, Maria Moreira, Isabel Barradas, Maria Molinos, Laetitia Teixeira, José Tulha, Rosmaninho Seabra, Jorge Lains, Virgílio Bento. Originally published in JMIR Rehabilitation and Assistive Technology (http://rehab.jmir.org), 28.02.2019. 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3761-8c2a6c3723a2c91182e899f26647fe2d32bb4d7fffe90449d06cebff76e713193</citedby><cites>FETCH-LOGICAL-c3761-8c2a6c3723a2c91182e899f26647fe2d32bb4d7fffe90449d06cebff76e713193</cites><orcidid>0000-0001-6091-3993 ; 0000-0002-9272-0149 ; 0000-0002-1625-4406 ; 0000-0002-9511-5008 ; 0000-0002-8737-7569 ; 0000-0003-2608-5156 ; 0000-0002-7562-928X ; 0000-0002-9679-4639 ; 0000-0001-5406-1165 ; 0000-0001-8028-926X ; 0000-0002-9276-3683 ; 0000-0001-6025-8511</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2509293109/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2509293109?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,37013,44590,53791,53793,75126</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30816849$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Correia, Fernando Dias</creatorcontrib><creatorcontrib>Nogueira, André</creatorcontrib><creatorcontrib>Magalhães, Ivo</creatorcontrib><creatorcontrib>Guimarães, Joana</creatorcontrib><creatorcontrib>Moreira, Maria</creatorcontrib><creatorcontrib>Barradas, Isabel</creatorcontrib><creatorcontrib>Molinos, Maria</creatorcontrib><creatorcontrib>Teixeira, Laetitia</creatorcontrib><creatorcontrib>Tulha, José</creatorcontrib><creatorcontrib>Seabra, Rosmaninho</creatorcontrib><creatorcontrib>Lains, Jorge</creatorcontrib><creatorcontrib>Bento, Virgílio</creatorcontrib><title>Medium-Term Outcomes of Digital Versus Conventional Home-Based Rehabilitation After Total Knee Arthroplasty: Prospective, Parallel-Group Feasibility Study</title><title>JMIR rehabilitation and assistive technologies</title><addtitle>JMIR Rehabil Assist Technol</addtitle><description>Physical rehabilitation is recommended after total knee arthroplasty (TKA). With the expected increase in TKA over the next few decades, it is important to find new ways of delivering cost-effective interventions. Technological interventions have been developed with this intent, but only preliminary evidence exists regarding their validity, with short follow-up times.
This study aimed to present the follow-up results of a feasibility study comparing two different home-based programs after TKA: conventional face-to-face sessions and a digital intervention performed through the use of an artificial intelligence-powered biofeedback system under remote clinical monitoring.
The digital intervention uses a motion tracker allowing 3D movement quantification, a mobile app and a Web portal. This study presents the results of the previous single-center, prospective, parallel-group, feasibility study including an 8-week active treatment stage and further assessments at 3 and 6 months post-TKA. Primary outcome was the Timed Up and Go score, and secondary outcomes were the Knee Osteoarthritis Outcome Scale (KOOS) score and knee range of motion.
A total of 59 patients completed the study (30 in the digital intervention group and 29 in the conventional rehabilitation group) and follow-up assessments. During the active treatment stage, patients in the digital intervention group demonstrated high engagement and satisfaction levels, with an 82% retention rate. Both groups attained clinically relevant improvements from baseline to 6 months post-TKA. At the end of the 8-week program, clinical outcomes were superior in the digital intervention group. At the 3- and 6-month assessments, the outcomes remained superior for the Timed Up and Go score (P<.001) and all KOOS subscale scores (at 3 months, P<.001 overall; at 6 months, KOOS Symptoms: P=.006, Pain: P=.002, Activities of Daily Living: P=.001, Sports: P=.003, and Quality of Life: P=.001). There was progressive convergence between both groups in terms of the knee range of motion, which remained higher for standing flexion in the digital intervention group than the conventional group at 6 months (P=.01). For the primary outcome, at 6 months, the median difference between groups was 4.87 seconds (95% CI 1.85-7.47), in favor of the digital intervention group.
The present study demonstrates that this novel digital intervention for independent home-based rehabilitation after TKA is feasible, engaging, and capable of maximizing clinical outcomes in comparison to conventional rehabilitation in the short and medium term; in addition, this intervention is far less demanding in terms of human resources.
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Nogueira, André ; Magalhães, Ivo ; Guimarães, Joana ; Moreira, Maria ; Barradas, Isabel ; Molinos, Maria ; Teixeira, Laetitia ; Tulha, José ; Seabra, Rosmaninho ; Lains, Jorge ; Bento, Virgílio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3761-8c2a6c3723a2c91182e899f26647fe2d32bb4d7fffe90449d06cebff76e713193</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Activities of daily living</topic><topic>Arthritis</topic><topic>Artificial intelligence</topic><topic>Biofeedback</topic><topic>Caregivers</topic><topic>Costs</topic><topic>Feasibility studies</topic><topic>Hospitals</topic><topic>Joint replacement surgery</topic><topic>Joint surgery</topic><topic>Knee</topic><topic>Medicare</topic><topic>Original Paper</topic><topic>Osteoarthritis</topic><topic>Patients</topic><topic>Physical therapists</topic><topic>Physical therapy</topic><topic>Rehabilitation</topic><topic>Surgical outcomes</topic><topic>Telemedicine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Correia, Fernando Dias</creatorcontrib><creatorcontrib>Nogueira, André</creatorcontrib><creatorcontrib>Magalhães, Ivo</creatorcontrib><creatorcontrib>Guimarães, Joana</creatorcontrib><creatorcontrib>Moreira, Maria</creatorcontrib><creatorcontrib>Barradas, Isabel</creatorcontrib><creatorcontrib>Molinos, Maria</creatorcontrib><creatorcontrib>Teixeira, Laetitia</creatorcontrib><creatorcontrib>Tulha, José</creatorcontrib><creatorcontrib>Seabra, Rosmaninho</creatorcontrib><creatorcontrib>Lains, Jorge</creatorcontrib><creatorcontrib>Bento, Virgílio</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>Publicly Available Content (ProQuest)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>JMIR rehabilitation and assistive technologies</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Correia, Fernando Dias</au><au>Nogueira, André</au><au>Magalhães, Ivo</au><au>Guimarães, Joana</au><au>Moreira, Maria</au><au>Barradas, Isabel</au><au>Molinos, Maria</au><au>Teixeira, Laetitia</au><au>Tulha, José</au><au>Seabra, Rosmaninho</au><au>Lains, Jorge</au><au>Bento, Virgílio</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Medium-Term Outcomes of Digital Versus Conventional Home-Based Rehabilitation After Total Knee Arthroplasty: Prospective, Parallel-Group Feasibility Study</atitle><jtitle>JMIR rehabilitation and assistive technologies</jtitle><addtitle>JMIR Rehabil Assist Technol</addtitle><date>2019-02-28</date><risdate>2019</risdate><volume>6</volume><issue>1</issue><spage>e13111</spage><epage>e13111</epage><pages>e13111-e13111</pages><issn>2369-2529</issn><eissn>2369-2529</eissn><abstract>Physical rehabilitation is recommended after total knee arthroplasty (TKA). With the expected increase in TKA over the next few decades, it is important to find new ways of delivering cost-effective interventions. Technological interventions have been developed with this intent, but only preliminary evidence exists regarding their validity, with short follow-up times.
This study aimed to present the follow-up results of a feasibility study comparing two different home-based programs after TKA: conventional face-to-face sessions and a digital intervention performed through the use of an artificial intelligence-powered biofeedback system under remote clinical monitoring.
The digital intervention uses a motion tracker allowing 3D movement quantification, a mobile app and a Web portal. This study presents the results of the previous single-center, prospective, parallel-group, feasibility study including an 8-week active treatment stage and further assessments at 3 and 6 months post-TKA. Primary outcome was the Timed Up and Go score, and secondary outcomes were the Knee Osteoarthritis Outcome Scale (KOOS) score and knee range of motion.
A total of 59 patients completed the study (30 in the digital intervention group and 29 in the conventional rehabilitation group) and follow-up assessments. During the active treatment stage, patients in the digital intervention group demonstrated high engagement and satisfaction levels, with an 82% retention rate. Both groups attained clinically relevant improvements from baseline to 6 months post-TKA. At the end of the 8-week program, clinical outcomes were superior in the digital intervention group. At the 3- and 6-month assessments, the outcomes remained superior for the Timed Up and Go score (P<.001) and all KOOS subscale scores (at 3 months, P<.001 overall; at 6 months, KOOS Symptoms: P=.006, Pain: P=.002, Activities of Daily Living: P=.001, Sports: P=.003, and Quality of Life: P=.001). There was progressive convergence between both groups in terms of the knee range of motion, which remained higher for standing flexion in the digital intervention group than the conventional group at 6 months (P=.01). For the primary outcome, at 6 months, the median difference between groups was 4.87 seconds (95% CI 1.85-7.47), in favor of the digital intervention group.
The present study demonstrates that this novel digital intervention for independent home-based rehabilitation after TKA is feasible, engaging, and capable of maximizing clinical outcomes in comparison to conventional rehabilitation in the short and medium term; in addition, this intervention is far less demanding in terms of human resources.
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| ispartof | JMIR rehabilitation and assistive technologies, 2019-02, Vol.6 (1), p.e13111-e13111 |
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| source | Open Access: PubMed Central; Publicly Available Content (ProQuest) |
| subjects | Activities of daily living Arthritis Artificial intelligence Biofeedback Caregivers Costs Feasibility studies Hospitals Joint replacement surgery Joint surgery Knee Medicare Original Paper Osteoarthritis Patients Physical therapists Physical therapy Rehabilitation Surgical outcomes Telemedicine |
| title | Medium-Term Outcomes of Digital Versus Conventional Home-Based Rehabilitation After Total Knee Arthroplasty: Prospective, Parallel-Group Feasibility Study |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-05T06%3A41%3A03IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Medium-Term%20Outcomes%20of%20Digital%20Versus%20Conventional%20Home-Based%20Rehabilitation%20After%20Total%20Knee%20Arthroplasty:%20Prospective,%20Parallel-Group%20Feasibility%20Study&rft.jtitle=JMIR%20rehabilitation%20and%20assistive%20technologies&rft.au=Correia,%20Fernando%20Dias&rft.date=2019-02-28&rft.volume=6&rft.issue=1&rft.spage=e13111&rft.epage=e13111&rft.pages=e13111-e13111&rft.issn=2369-2529&rft.eissn=2369-2529&rft_id=info:doi/10.2196/13111&rft_dat=%3Cproquest_pubme%3E2187024972%3C/proquest_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c3761-8c2a6c3723a2c91182e899f26647fe2d32bb4d7fffe90449d06cebff76e713193%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2509293109&rft_id=info:pmid/30816849&rfr_iscdi=true |