JMIR Publications

ABSTRACT

Background:

Degenerative cervical spine disease is a common health issue worldwide, particularly prevalent in the elderly population. Data show that its prevalence reaches 27.3% in the general population and and increases with age[1-2]. This condition not only severely impacts patients’ quality of life but it also imposes a considerable strain on the healthcare systems. Among various treatment options, Anterior Cervical Discectomy and Fusion (ACDF) is a common surgical procedure[3-5]. However, several challenges persist in the post-ACDF rehabilitation process. Due to the short duration of hospital stay, patients are required to continue their rehabilitation at home, resulting in a lack of professional monitoring and guidance[6-7]. Current rehabilitation methods largely rely on traditional physical therapy and periodic outpatient follow-ups, limiting the ability for continuous monitoring and immediate feedback. Secondly, various complications such as dysphagia, hematoma, and respiratory dysfunction may accompany the post-ACDF period. The lack of effective post-surgery monitoring and personalized rehabilitation plans may lead to increased rates of complications. Furthermore, traditional rehabilitation methods often overlook mental health, leading to inadequate support for patients in emotional management and psychological adjustment. It is shown that changes in post-surgical function can significantly impact patients psychologically[8]. To address the challenges in post-ACDF rehabilitation, this study developed an innovative digital rehabilitation technology aimed at improving post-surgery outcomes. This technology first incorporates computer vision to guide rehabilitation exercises. Additionally, integrating cognitive-behavioral therapy improves patients' psychological states, aiming to improve their self-efficacy throughout the rehabilitation process. Moreover, the use of inertial sensor monitoring technology allows for real-time tracking of the cervical spine's movement, providing timely feedback to patients regarding abnormal postures. The comprehensive application of these technologies forms a data-driven, personalized digital rehabilitation program, offering a novel solution for post-ACDF rehabilitation.

Objective:

This study analyzed the impact of an innovative digital rehabilitation program in improving neck pain, quality of life, and function in patients following Anterior Cervical Discectomy and Fusion (ACDF) surgery.

Methods:

The digital rehabilitation program integrated computer vision guided exercise, cognitive-behavioral therapy, and sensor-based posture monitoring to provide comprehensive patient management. A total of 336 post-ACDF patients were included in this study. Data was analyzed according to three cohorts, patients who completed digital rehabilitation program (DCG), patients who started but did not complete digital rehabilitation program (DNG), and patients who opted for in-person rehabilitation (IRG). Evaluation was conducted before surgery, at 12 weeks, and 24 weeks post-surgery. The assessments included Cervical Spine Mobility, Muscle Endurance Testing, Visual Analog Scale (VAS), Neck Disability Index (NDI), SF-36 Mental Component Summary (SF-36 MCS), and Patient Satisfaction Questionnaire (PSQ).

Results:

The study found that both the DCG and the IRG showed significant improvements in cervical mobility, muscle endurance, pain reduction, and mental health, with no significant differences between the two groups (p > 0.05).

Conclusions:

The digital rehabilitation program effectively improved neck pain, NDI score, cervical spine function, and mental health. Its is comparable to in-person rehabilitation and superior to standard of care management. Clinical Trial: I-22YJ703