JMIR Publications

ABSTRACT

Background:

Knee osteoarthritis (KOA) requires long-term treatment that faces significant barriers, including inadequate physiotherapy services, especially in Slovenia and comparable European countries. Mobile health applications offer a promising solution to improve accessibility and adherence to KOA treatment.

Objective:

This study aimed to identify KOA patients’ expectations for app-based therapy, determine the functional requirements, and assess the main barriers and benefits of using mobile apps for KOA management. It also examined these factors in relation to demographic data (gender, age, and education level) and motivation to perform knee exercises.

Methods:

A mixed-methods approach was used, integrating quantitative and qualitative data collected via a questionnaire and in-depth interviews, respectively. We included a purposive sample of 82 patients with symptomatic KOA graded 1−3 on the Kellgren-Lawrence scale, excluding those with cognitive impairments, wheelchair dependency, comorbidities, or impaired language skills.

Results:

The analysis revealed that 53.7% of patients preferred using smartphones, and 40.2% preferred PCs for remote KOA management due to their accessibility and convenience. Exercise videos were the highest-rated feature (µ = 9.45), followed by goal setting and tracking (µ = 8.95) and regular e-messages (µ = 8.83). Telephone calls with physiotherapists were also highly valued (µ = 8.41). We observed significant differences in the perceived importance of key information about the disease (F = 2.077, p = 0.043) and exercise videos (F = 2.788, p = 0.007) based on motivation levels but not gender, age, or education. Opinions on the appropriate duration of physical activity did not differ significantly across gender, age, or education but varied with motivation levels (F = 2.490, p = 0.015). Compared to women, men recorded higher ratings for the ease of use (4.71 vs 4.93; F = 3.961, p = 0.050) and clarity of the exercise flow display. The highest-rated barrier was inaccurate information about the disease (µ = 3.96), with significant differences across age groups. Younger participants (<40) and those aged 51–60 reported major concerns about time management and information accuracy. The patients valued the ability to view exercises multiple times as a major beneficial app function and emphasised saving time and easier access to physiotherapists, which were highly valued for convenience. Improved communication and information were deemed crucial for trust and effective treatment.

Conclusions:

Mobile health apps for KOA management should prioritise user-centred features such as accessibility, motivation, and clear communication. Key elements include high-quality exercise videos, goal setting, symptom tracking, and regular e-messages. Addressing barriers and providing age-specific features can improve KOA management and patient quality of life and can aid in developing user-friendly mobile health apps that improve KOA management and enhance patients’ quality of life, particularly in countries with limited access to physiotherapy, such as Slovenia.