Accepted for/Published in: JMIR Rehabilitation and Assistive Technologies
Date Submitted: Apr 29, 2019
Date Accepted: May 31, 2019
Digital Versus Conventional Rehabilitation After Total Hip Arthroplasty: a Single-Center, Parallel-Group, Pilot Study
ABSTRACT
Background:
The demand for total hip arthroplasty (THA) is rising. In the face of galloping healthcare costs, ensuring widespread cost-effective rehabilitation is a priority. Technologies allowing independent home-based rehabilitation may be the key to facilitate access, improve effectiveness and lower costs of care.
Objective:
To assess the feasibility of a novel AI-powered digital biofeedback system following THA and compare the clinical outcomes against supervised conventional rehabilitation.
Methods:
This was a single-center, parallel-group, pilot study, with an 8-week intervention program. Patients were assessed at baseline, during the program (4 and 8 weeks) and 3 and 6 months after surgery. The primary outcome was the Timed Up and Go (TUG) score and secondary outcomes were the Hip Osteoarthritis Outcome Scale (HOOS - a patient reported outcome) and hip range of motion (ROM).
Results:
Sixty-six patients were included (35 digital physiotherapy (PT) vs 31 conventional). There were no differences at baseline between groups except for lower HOOS - quality of life (QoL) scores in the digital PT group. Clinically relevant improvements were noted in both groups at all timepoints. The digital PT group showed a retention rate of 86%. Per protocol analysis revealed a superiority of the digital PT group for all outcome measures. Intention to treat analysis revealed the superiority of the digital PT group in all time-points for TUG (change between baseline and 4 and 8 weeks: P<.001; change between baseline and 3 and 6 months: P=.001 and P=.005, respectively), with a difference between median changes of 4.79 seconds (95% CI: -7.24;-1.71) at 6 months post-THA. Between baseline and month 6, results were also superior in the digital PT group for HOOS-Sports and HOOS-QoL and all ROM except for standing flexion.
Conclusions:
This study demonstrates this novel solution holds great promise in rehabilitation after THA, ensuring better clinical outcomes than conventional rehabilitation while reducing dependence on human resources. Clinical Trial: Clinicaltrials.gov NCT03045549
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