JMIR Publications

ABSTRACT

Background:

Digital technologies have become common in postoperative orthopaedic rehabilitation. The tendency towards this adoption appeared in the past decade. However, no standard method exists to classify their functional capabilities. This absence hinders practical implementation. Clinicians struggle to describe differences different technologies effectively.

Objective:

This scoping review aims to map digital interventions used in post-surgical orthopaedic rehabilitation to the Coordination, Alignment, Motivation, and Strength (CAMS) framework and to identify research trends, functional coverage, and gaps in current evidence.

Methods:

A systematic search was performed in six databases, such as medical (PubMed/EMBASE), and technical (IEEE/ACM), using the PRISMA-ScR guidelines. Research papers undergoing digital interventions in post-surgical orthopaedic recovery were mapped to four CAMS pillars. The Cochrane Risk of Bias 2 (RoB 2) tool and PEDro scale were used to characterise the methodological profile of included studies, as quality appraisal in scoping reviews is descriptive rather than evaluative.

Results:

Twenty-three studies (n=23) met the inclusion criteria. Motivation (M) was the most frequently addressed pillar (96%, n=22), followed by Coordination (C) (87%, n=20). Alignment (A) was addressed in 30% of studies (n=7), while Strength (S) was the least represented pillar (35%, n=8). Sixty-five percent of studies (n=15) were rated Low Risk overall on the Cochrane RoB 2 tool, with performance bias identified as a consistent concern across the corpus. Delivery models were predominantly hybrid (61%, n=14) or home-based (35%, n=8), with only one study (4%, n=1) employing an exclusively clinical model.

Conclusions:

Digital health has shown notable increase in the kinematic monitoring feature, offering effective solutions to psychological engagement (Motivation) and movement quality (Coordination/Alignment). Nevertheless, there is a consistent gap in strength-related studies, as current decentralized tools lack the capability to quantify physiological load. The next phase of innovations should be a shift to integrated 4-pillar solutions that would coordinate resistance-based training with high-precision biomechanical monitoring. The CAMS framework is a roadmap for the next generation of holistic orthopaedic recovery.