Previously submitted to: JMIR Rehabilitation and Assistive Technologies (no longer under consideration since Jun 01, 2021)
Date Submitted: Oct 3, 2020
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Effect of a Wearable Motion Sensor Device in Facilitating In-Home Rehabilitation Program in Patients After Total Knee Arthroplasty
ABSTRACT
Background:
Total knee arthroplasty (TKA) is an effective procedure for patients with end-stage knee osteoarthritis. Postoperative rehabilitation programs are essential for facilitating functional recovery after TKA. However, clinical results vary because of inconsistent patient compliance.
Objective:
This study aimed to verify the feasibility of a treatment model that involves applying a wearable motion sensor device (MSD) to assist patients in performing home-based exercises after TKA.
Methods:
The MSD comprised inertial measurement unit–based sensors and mobile apps for patients and physicians, which allowed for knee mobility tracing, home-based exercise support, and progress monitoring. The interrater reliability of knee mobility measurements was assessed using the intraclass correlation coefficient (ICC). Different knee flexion angles and the time spent for completing the 5-times sit-to-stand test (5TSST) in 12 healthy participants were measured by 2 experienced physicians and using the MSD, and their results were compared using ICC. A pilot prospective control trial was then conducted, in which 12 patients following TKA were allocated to 2 groups: the home-based exercise group and the MSD-assisted rehabilitation group. Changes in knee range of motion, pain, functional score (assessed using the Western Ontario and McMaster Universities Arthritis Index), performance (tested using 5TSST), and exercise completion rates were compared between the groups over 2 months of follow-up.
Results:
Knee flexion at different angles and the time spent for completing 5TSST measured using the MSD exhibited excellent reliability compared with the physician measurements (ICC range: 0.996 and 0.996 respectively). Furthermore, patients in the MSD-assisted rehabilitation group reported higher exercise completion rate within 2 months of the in-home exercise program compared with participants in the home-based exercise group, which lead to more favorable outcomes in the knee extension angle and maximal and average angular velocity in 5TSST.
Conclusions:
MSD-assisted home-based rehabilitation following TKA is a useful treatment model for telerehabilitation because it enhances patients’ compliance to training, which improves functional recovery. This method helps overcome critical obstacles in home-based physiotherapy among patients after TKA. Therefore, this study has crucial implications for patients and health systems.
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