Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Dec 20, 2020
Date Accepted: Apr 19, 2021
Comparison of app-based correction feedback to exercise correction by physiotherapists in patients with osteoarthritis of the knee and/or hip: A prospective cohort study
ABSTRACT
Background:
The use of digital therapeutic solutions for rehabilitation of musculoskeletal pain conditions like osteoarthritis (OA) is an increasingly important way to provide scalable access to rehabilitation. While few validated technological solutions exist to ensure supervision of users while doing home-based exercises, the Motion Coach technology provides a software solution that can provide audiovisual feedback on exercise execution in real-time on conventional smartphones.
Objective:
We set the hypothesis that the interrater agreement between physiotherapists (PTs) and the Motion Coach (MC) technology on exercise corrections in an OA cohort would be non-inferior to the PT interrater agreement.
Methods:
Patients diagnosed with OA of the knee and/or hip were recruited at a university hospital to perform a set of six exercises and the corrections triggered by the MC or two PTs, for predefined segments, were compared regarding interrater agreement.
Results:
24 participants were enrolled and performed the assessments. The interrater agreements showed an accuracy of 0.828 (App vs PTs) vs. 0.833 (PT1 vs PT2), P <0.001 and confirmed non-inferiority of the MC to PTs. Subgroup analysis based on age with a split of 70 years or under, gender and Body-Mass-Index (BMI) with a split of 30 or under revealed no detectable difference in interrater agreement in any subgroup. There was no detectable difference in levels of interrater agreement between MC vs. PTs and PTs themselves in any of the six exercises, regardless of exercise pose or exercise difficulty levels.
Conclusions:
The interrater agreement for suggesting corrections during therapeutic exercises observed in the current study did not differ between two PTs among each other and PTs and the Motion Coach. This finding was valid for all investigated exercises and subgroups. These results confirm the ability of the Motion Coach technology to detect form during exercise and provide valid feedback to users with preexisting musculoskeletal disorders. Clinical Trial: The study was registered with the German Study Registry (DRKS) prior to beginning of enrollment (DRKS registry number DRKS00021828).
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