Clinical trial NCT05434767: Evaluating the Feasibility and Effectiveness of Using a Smartphone Application During Rehabilitation in Patients After Total Knee Replacement
Official title: Evaluating the Feasibility and Effectiveness of Using a Smartphone Application During Rehabilitation in Patients After Total Knee Replacement: A Pilot Feasibility Randomized Controlled Trial
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Total Knee Replacement
Total Knee Arthroplasty
Lead sponsor: Singapore General Hospital
Sponsor class: OTHER
First posted: 2022-06-28
Enrollment: 30
Sex: ALL
Minimum age (years): 45
Maximum age (years): 100
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: 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.


Eligibility criteria: 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

Primary outcomes:
measure: Compliance
timeFrame: 6 weeks post-surgery
Secondary outcomes:
measure: Knee range-of-motion
timeFrame: Pre-operation; 6 weeks post-surgery
measure: Gait speed
timeFrame: Pre-operation; 6 weeks post-surgery
measure: Knee Pain
timeFrame: Pre-operation; 6 weeks post-surgery
measure: 30 second sit to stand
timeFrame: Pre-operation; 6 weeks post-surgery
measure: Self-report physical function
timeFrame: Pre-operation; 6 weeks post-surgery
measure: Self-efficacy
timeFrame: Pre-operation; 6 weeks post-surgery
measure: Total contact time
timeFrame: 6 weeks post-surgery
measure: Quality of the mobile application
timeFrame: 6 weeks post-surgery
measure: Participant satisfaction
timeFrame: 6 weeks post-surgery
measure: Treatment credibility
timeFrame: 6 weeks post-surgery
measure: Perceived usefulness and ease of use
timeFrame: 6 weeks post-surgery
Other outcomes:
Locations:
city: Singapore
country: Singapore
facility: Singapore General Hospital
Study officials:
References: