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Medium-Term Outcomes of Digital Versus Conventional Home-Based Rehabilitation After Total Knee Arthroplasty: Prospective, Parallel-Group Feasibility Study

2019-02-28Journal article Open access
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dc.contributor.authorDias Correia, Fernando
dc.contributor.authorNogueira, André
dc.contributor.authorMagalhães, Ivo
dc.contributor.authorGuimarães, Joana
dc.contributor.authorMoreira, Maria Excelsa
dc.contributor.authorBarradas, Isabel
dc.contributor.authorMolinos, Maria
dc.contributor.authorTeixeira, Laetitia
dc.contributor.authorTulha, José
dc.contributor.authorSeabra, Rosmaninho
dc.contributor.authorLains, Jorge
dc.contributor.authorBento, Virgílio
dc.date.accessioned2020-05-27T15:04:09Z
dc.date.available2020-05-27T15:04:09Z
dc.date.issued2019-02-28
dc.description.abstractBackground: 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. Objective: 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. Methods: 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. Results: 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. Conclusions: 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.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationCorreia FD, Nogueira A, Magalhães I, et al. Medium-Term Outcomes of Digital Versus Conventional Home-Based Rehabilitation After Total Knee Arthroplasty: Prospective, Parallel-Group Feasibility Study. JMIR Rehabil Assist Technol. 2019;6(1):e13111. Published 2019 Feb 28. doi:10.2196/13111pt_PT
dc.identifier.doi10.2196/13111pt_PT
dc.identifier.issn2369-2529
dc.identifier.urihttp://hdl.handle.net/10400.16/2404
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherJMIR Publicationspt_PT
dc.relationAdvanced Analytics Platform for Stroke Patients Rehabilitation
dc.relation.publisherversionhttps://rehab.jmir.org/2019/1/e13111/pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/pt_PT
dc.subjectkneept_PT
dc.subjectTKApt_PT
dc.subjectartificial intelligencept_PT
dc.subjectdigital physiotherapistpt_PT
dc.subjecteHealthpt_PT
dc.subjecthome-based telerehabilitationpt_PT
dc.titleMedium-Term Outcomes of Digital Versus Conventional Home-Based Rehabilitation After Total Knee Arthroplasty: Prospective, Parallel-Group Feasibility Studypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.awardTitleAdvanced Analytics Platform for Stroke Patients Rehabilitation
oaire.awardURIinfo:eu-repo/grantAgreement/EC/H2020/672814/EU
oaire.citation.conferencePlaceCanadapt_PT
oaire.citation.issue1pt_PT
oaire.citation.startPagee13111pt_PT
oaire.citation.titleJMIR rehabilitation and assistive technologiespt_PT
oaire.citation.volume6pt_PT
oaire.fundingStreamH2020
person.familyNameDias Correia
person.familyNameNogueira
person.familyNameMagalhães
person.familyNameGuimarães
person.familyNameMoreira
person.familyNameBarradas
person.familyNameMolinos
person.familyNameTeixeira
person.familyNameTulha
person.familyNameSeabra
person.familyNameLains
person.familyNameBento
person.givenNameFernando
person.givenNameAndré
person.givenNameIvo
person.givenNameJoana
person.givenNameMaria Excelsa
person.givenNameIsabel
person.givenNameMaria
person.givenNameLaetitia
person.givenNameJosé
person.givenNameRosmaninho
person.givenNameJorge
person.givenNameVirgílio
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person.identifier.orcid0000-0001-6025-8511
person.identifier.ridM-4124-2013
person.identifier.scopus-author-id42762288100
project.funder.identifierhttp://doi.org/10.13039/501100008530
project.funder.nameEuropean Commission
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
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