Development of a mobile application to improve exercise accuracy and quality of life in knee osteoarthritis patients: a randomized controlled trial.
Knee exercises
Knee osteoarthritis
Mobile application
Rehabilitation
Smartphone application
Journal
Archives of orthopaedic and trauma surgery
ISSN: 1434-3916
Titre abrégé: Arch Orthop Trauma Surg
Pays: Germany
ID NLM: 9011043
Informations de publication
Date de publication:
Feb 2023
Feb 2023
Historique:
received:
25
04
2021
accepted:
23
08
2021
pubmed:
29
8
2021
medline:
16
2
2023
entrez:
28
8
2021
Statut:
ppublish
Résumé
Knee Osteoarthritis (OA) is a degenerative joint disease that needs consistent exercise and an accurate understanding of the condition for long-term maintenance. While the accessibility of outpatient care is essential for disease management, many patients lack the resources to receive adequate healthcare. To address this challenge, we developed a not-for-profit interactive mobile application that provides a disease-specific educational background and a structured exercise regimen to patients. "Rak Kao" (English translation: Love-Your-Knee) mobile application was designed to analyze the questionnaire data to assess the stage of knee OA and generate a personalized recommendation of treatment and exercise type using rule-based and Artificial Intelligence (AI) techniques. A single-blinded study was conducted with patients (n = 82) who were randomly assigned to the mobile application group (M-group) and the handout group (H-group). Patient groups were controlled for age, gender, BMI, onset of pain, grade of disease, education level, and occupation. Accuracy in performance of three prescribed knee exercises (catch-bend-down, stretch-touch-feet, and sit-stretch-hold) was evaluated. Clinical outcomes were evaluated before and after the 4-weeks program to assess the range of motion, symptoms, pain, physical activity, and quality of life via the KOOS and KSS scores. Completion of the study led to significantly more overall exercise accuracy in the M-group (76.2%) than the H-group (52.5%). Activities of daily life, quality of life, ability to do sports and recreational activities were significantly more improved in the M-group than the H-group (p < .01). No difference in the range of motion between groups. Satisfaction of patients' experience was higher in the M-group than the H-group (p = .001) after the 4-week regimen. With the better accuracy and outcomes for rehabilitation in the M-group than the H-group, we strongly recommend using our mobile application as a better alternative than handouts for exercises and information for patients with knee OA. ClinicalTrials.gov: NCT03666585.
Identifiants
pubmed: 34453570
doi: 10.1007/s00402-021-04149-8
pii: 10.1007/s00402-021-04149-8
pmc: PMC8397851
doi:
Banques de données
ClinicalTrials.gov
['NCT03666585']
Types de publication
Randomized Controlled Trial
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
729-738Subventions
Organisme : Navamindradhiraj University Research Fund
ID : 8-2561
Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Cui A, Li H, Wang D, Zhong J, Chen Y, Lu H (2020) Global, regional prevalence, incidence and risk factors of knee osteoarthritis in population-based studies. EClinicalMedicine 29–30:100587. https://doi.org/10.1016/j.eclinm.2020.100587
doi: 10.1016/j.eclinm.2020.100587
van Middelkoop M, Bennell KL, Callaghan MJ, Collins NJ, Conaghan PG, Crossley KM, Eijkenboom J, van der Heijden RA, Hinman RS, Hunter DJ, Meuffels DE, Mills K, Oei EHG, Runhaar J, Schiphof D, Stefanik JJ, Bierma-Zeinstra SMA (2018) International patellofemoral osteoarthritis consortium: consensus statement on the diagnosis, burden, outcome measures, prognosis, risk factors and treatment. Semin Arthritis Rheum 47(5):666–675. https://doi.org/10.1016/j.semarthrit.2017.09.009
doi: 10.1016/j.semarthrit.2017.09.009
Hurley M, Dickson K, Hallett R, Grant R, Hauari H, Walsh N, Stansfield C, Oliver S (2018) Exercise interventions and patient beliefs for people with hip, knee or hip and knee osteoarthritis: a mixed methods review. Cochrane Database Syst Rev 4(4):CD010842. https://doi.org/10.1002/14651858.CD010842.pub2
doi: 10.1002/14651858.CD010842.pub2
Collins NJ, Hart HF, Mills KAG (2019) Osteoarthritis year in review 2018: rehabilitation and outcomes. Osteoarthritis Cartilage 27(3):378–391. https://doi.org/10.1016/j.joca.2018.11.010
doi: 10.1016/j.joca.2018.11.010
Kanavaki AM, Rushton A, Efstathiou N, Alrushud A, Klocke R, Abhishek A, Duda JL (2017) Barriers and facilitators of physical activity in knee and hip osteoarthritis: a systematic review of qualitative evidence. BMJ Open 7(12):e017042. https://doi.org/10.1136/bmjopen-2017-017042
doi: 10.1136/bmjopen-2017-017042
Dobson F, Bennell KL, French SD, Nicolson PJ, Klaasman RN, Holden MA, Atkins L, Hinman RS (2016) Barriers and facilitators to exercise participation in people with hip and/or knee osteoarthritis: synthesis of the literature using behavior change theory. Am J Phys Med Rehabil 95(5):372–389. https://doi.org/10.1097/phm.0000000000000448
doi: 10.1097/phm.0000000000000448
Administration UFaD Policy for devices software function and mobile medical application.
Mrklas KJ, Barber T, Campbell-Scherer D, Green LA, Li LC, Marlett N, Miller J, Shewchuk B, Teare S, Wasylak T, Marshall DA (2020) Co-design in the development of a mobile health app for the management of knee osteoarthritis by patients and physicians: qualitative study. JMIR Mhealth Uhealth 8(7):e17893. https://doi.org/10.2196/17893
doi: 10.2196/17893
Ventola CL (2014) Mobile devices and apps for health care professionals: uses and benefits. P t 39(5):356–364
Rabin A, Dolkart O, Kazum E, Wengier R, Goldstein Y, Maman E, Chechik O (2021) Shoulder assessment by smartphone: a valid alternative for times of social distancing. Arch Orthop Trauma Surg. https://doi.org/10.1007/s00402-021-03762-x
doi: 10.1007/s00402-021-03762-x
Singler K, Roth T, Beck S, Cunningham M, Gosch M (2016) Development and initial evaluation of a point-of-care educational app on medical topics in orthogeriatrics. Arch Orthop Trauma Surg 136(1):65–73. https://doi.org/10.1007/s00402-015-2366-8
doi: 10.1007/s00402-015-2366-8
Mitchell HL, Hurley MV (2008) Management of chronic knee pain: a survey of patient preferences and treatment received. BMC Musculoskelet Disord 9:123. https://doi.org/10.1186/1471-2474-9-123
doi: 10.1186/1471-2474-9-123
Holden MA, Nicholls EE, Young J, Hay EM, Foster NE (2012) Role of exercise for knee pain: what do older adults in the community think? Arthritis Care Res (Hoboken) 64(10):1554–1564. https://doi.org/10.1002/acr.21700
doi: 10.1002/acr.21700
pubmed: 22511582
Choi W, Zheng H, Franklin P, Tulu B (2019) mHealth technologies for osteoarthritis self-management and treatment:a systematic review. Health Informatics J 25(3):984–1003. https://doi.org/10.1177/1460458217735676
doi: 10.1177/1460458217735676
Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K, Christy W, Cooke TD, Greenwald R, Hochberg M et al (1986) Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and therapeutic criteria committee of the american rheumatism association. Arthritis Rheum 29(8):1039–1049. https://doi.org/10.1002/art.1780290816
doi: 10.1002/art.1780290816
Kellgren JH, Lawrence JS (1957) Radiological assessment of osteo-arthrosis. Ann Rheum Dis 16(4):494–502. https://doi.org/10.1136/ard.16.4.494
doi: 10.1136/ard.16.4.494
Roos EM, Lohmander LS (2003) The Knee injury and Osteoarthritis Outcome Score (KOOS): from joint injury to osteoarthritis. Health Qual Life Outcomes 1:64–64. https://doi.org/10.1186/1477-7525-1-64
doi: 10.1186/1477-7525-1-64
Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 248:13–14
doi: 10.1097/00003086-198911000-00004
Thiengwittayaporn S, Wetpiryakul P, Foosakun Y, Ngamsom T, Vathanavit P, Pintongtun J (2009) Comparison of the accuracy of quadriceps isometric exercise between using quadriceps education device (QED) and not using QED for osteoarthritic knee patients: a randomized controlled trial. J Med Assoc Thai 92(Suppl 6):S33-38
Tanaka R, Ozawa J, Kito N, Moriyama H (2013) Efficacy of strengthening or aerobic exercise on pain relief in people with knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials. Clin Rehabil 27(12):1059–1071. https://doi.org/10.1177/0269215513488898
doi: 10.1177/0269215513488898
Uthman OA, van der Windt DA, Jordan JL, Dziedzic KS, Healey EL, Peat GM, Foster NE (2014) Exercise for lower limb osteoarthritis: systematic review incorporating trial sequential analysis and network meta-analysis. Br J Sports Med 48(21):1579. https://doi.org/10.1136/bjsports-2014-5555rep
doi: 10.1136/bjsports-2014-5555rep
Brosseau L, Taki J, Desjardins B, Thevenot O, Fransen M, Wells GA, Mizusaki Imoto A, Toupin-April K, Westby M, Álvarez Gallardo IC, Gifford W, Laferrière L, Rahman P, Loew L, De Angelis G, Cavallo S, Shallwani SM, Aburub A, Bennell KL, Van der Esch M, Simic M, McConnell S, Harmer A, Kenny GP, Paterson G, Regnaux JP, Lefevre-Colau MM, McLean L (2017) The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. Part two: strengthening exercise programs. Clin Rehabil 31(5):596–611. https://doi.org/10.1177/0269215517691084
doi: 10.1177/0269215517691084
Zhang W, Nuki G, Moskowitz RW, Abramson S, Altman RD, Arden NK, Bierma-Zeinstra S, Brandt KD, Croft P, Doherty M, Dougados M, Hochberg M, Hunter DJ, Kwoh K, Lohmander LS, Tugwell P (2010) OARSI recommendations for the management of hip and knee osteoarthritis: part III: changes in evidence following systematic cumulative update of research published through January 2009. Osteoarthritis Cartilage 18(4):476–499. https://doi.org/10.1016/j.joca.2010.01.013
doi: 10.1016/j.joca.2010.01.013
Zhang W, Moskowitz RW, Nuki G, Abramson S, Altman RD, Arden N, Bierma-Zeinstra S, Brandt KD, Croft P, Doherty M, Dougados M, Hochberg M, Hunter DJ, Kwoh K, Lohmander LS, Tugwell P (2008) OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. Osteoarthritis Cartilage 16(2):137–162. https://doi.org/10.1016/j.joca.2007.12.013
doi: 10.1016/j.joca.2007.12.013
Maly MR, Marriott KA, Chopp-Hurley JN (2020) Osteoarthritis year in review 2019: rehabilitation and outcomes. Osteoarthritis Cartilage 28(3):249–266. https://doi.org/10.1016/j.joca.2019.11.008
doi: 10.1016/j.joca.2019.11.008
Pisters MF, Veenhof C, Schellevis FG, Twisk JW, Dekker J, De Bakker DH (2010) Exercise adherence improving long-term patient outcome in patients with osteoarthritis of the hip and/or knee. Arthritis Care Res (Hoboken) 62(8):1087–1094. https://doi.org/10.1002/acr.20182
doi: 10.1002/acr.20182
pubmed: 20235201
Lambert TE, Harvey LA, Avdalis C, Chen LW, Jeyalingam S, Pratt CA, Tatum HJ, Bowden JL, Lucas BR (2017) An app with remote support achieves better adherence to home exercise programs than paper handouts in people with musculoskeletal conditions: a randomised trial. J Physiother 63(3):161–167. https://doi.org/10.1016/j.jphys.2017.05.015
doi: 10.1016/j.jphys.2017.05.015
Alasfour M, Almarwani M (2020) The effect of innovative smartphone application on adherence to a home-based exercise programs for female older adults with knee osteoarthritis in Saudi Arabia: a randomized controlled trial. Disabil Rehabil. https://doi.org/10.1080/09638288.2020.1836268
doi: 10.1080/09638288.2020.1836268
Bäcker HC, Wu CH, Schulz MRG, Weber-Spickschen TS, Perka C, Hardt S (2021) App-based rehabilitation program after total knee arthroplasty: a randomized controlled trial. Arch Orthop Trauma Surg. https://doi.org/10.1007/s00402-021-03789-0
doi: 10.1007/s00402-021-03789-0
Coleman S, Briffa NK, Carroll G, Inderjeeth C, Cook N, McQuade J (2012) A randomised controlled trial of a self-management education program for osteoarthritis of the knee delivered by health care professionals. Arthritis Res Ther 14(1):R21. https://doi.org/10.1186/ar3703
doi: 10.1186/ar3703
Khachian A, Seyedoshohadaei M, Haghani H, Amiri F (2020) Effect of self-management program on outcome of adult knee osteoarthritis. Int J Orthop Trauma Nurs 39:100797. https://doi.org/10.1016/j.ijotn.2020.100797
doi: 10.1016/j.ijotn.2020.100797
Bawa HS, Weick JW, Dirschl DR (2016) Gender disparities in osteoarthritis-related health care utilization before total knee arthroplasty. J Arthroplasty 31(10):2115-2118.e2111. https://doi.org/10.1016/j.arth.2016.03.044
doi: 10.1016/j.arth.2016.03.044
Bailey DL, Holden MA, Foster NE, Quicke JG, Haywood KL, Bishop A (2020) Defining adherence to therapeutic exercise for musculoskeletal pain: a systematic review. Br J Sports Med 54(6):326–331. https://doi.org/10.1136/bjsports-2017-098742
doi: 10.1136/bjsports-2017-098742
Hall AM, Kamper SJ, Hernon M, Hughes K, Kelly G, Lonsdale C, Hurley DA, Ostelo R (2015) Measurement tools for adherence to non-pharmacologic self-management treatment for chronic musculoskeletal conditions: a systematic review. Arch Phys Med Rehabil 96(3):552–562. https://doi.org/10.1016/j.apmr.2014.07.405
doi: 10.1016/j.apmr.2014.07.405
Schäfer AGM, Zalpour C, von Piekartz H, Hall TM, Paelke V (2018) The efficacy of electronic health-supported home exercise interventions for patients with osteoarthritis of the knee: systematic review. J Med Internet Res 20(4):e152. https://doi.org/10.2196/jmir.9465
doi: 10.2196/jmir.9465
Safari R, Jackson J, Sheffield D (2020) Digital self-management interventions for people with osteoarthritis: systematic review with meta-analysis. J Med Internet Res 22(7):e15365. https://doi.org/10.2196/15365
doi: 10.2196/15365
Petersen W, Karpinski K, Backhaus L, Bierke S, Häner M (2021) A systematic review about telemedicine in orthopedics. Arch Orthop Trauma Surg. https://doi.org/10.1007/s00402-021-03788-1
doi: 10.1007/s00402-021-03788-1