Accepted for/Published in: JMIR Rehabilitation and Assistive Technologies
Date Submitted: Apr 19, 2024
Date Accepted: Jan 9, 2025
Understanding Patient and Physiotherapist Requirements for a Personalised Automated Smartphone Tele-Monitored Application for Post-Total Knee Arthroplasty Rehabilitation: A Qualitative Study Informing User-Centred Design
ABSTRACT
Background:
Total knee arthroplasty (TKA) is cost-effective surgical intervention for painful knee osteoarthritis in older adults, but post-surgery rehabilitation access is limited. Tele-rehabilitation offers a solution, but existing models require significant therapist involvement and costly setup. A smartphone-based automated program could be a cost-effective alternative.
Objective:
To ensure uptake and long-term sustainability, our study adopted a user-centred approach. This study aimed to understand the requirements of both patients and physiotherapists in developing an automated tele-monitored rehabilitation smartphone application for individuals undergoing TKA.
Methods:
A multistakeholder qualitative study of user needs was conducted. Physiotherapists and patients who underwent TKA were recruited via purposive sampling. Individual in-depth interviews, lasting about an hour each, were conducted via zoom by an experienced, trained female interviewer with a Master of Arts in Sociology. Data were audio-recorded and transcribed by the same interviewer. Two reviewers (ESC, SSK) independently analysed the data using thematic analysis, with data triangulation achieved through cross-checking of data sources by three reviewers (ESC, SSK, AES). Interviews were conducted to data saturation.
Results:
Among the four eligible physiotherapists and 11 eligible patients invited, four physiotherapists (100%) and six patients (54.5%) consented and completed interviews. The median age of physiotherapists and patients were 27- and 65-years-old respectively. The majority of patients were Chinese (83%) and employed (67%). Common themes that emerged from both groups were that the application should be informative and provide reassurance. Additional themes from the patient group were: ease of use, and enhancing motivation and compliance.
Conclusions:
This study provided insights into the requirements of potential end-users of a smartphone application for automated tele-monitored rehabilitation following TKA. This is useful for steering the development of a user-centric smartphone application.
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