JMIR Publications

ABSTRACT

Background:

Knee osteoarthritis (OA) is a prevalent cause of disability among the elderly, emphasizing the need for effective and accessible self-management strategies. Mobile application based personalized exercise programs predominantly overcome the barriers associated with traditional approaches.

Objective:

This study evaluated the feasibility and preliminary efficacy of a 6-week mobile application–based self-exercise program that incorporates a multimonitoring system, weekly progress tracking, and dynamic exercise adjustments used by physiotherapists and compares them with those of a conventional paper-based self-exercise program in elderly patients with chronic knee OA.

Methods:

Twenty-nine participants aged ≥ 60 years with chronic knee pain and radiographic evidence of OA were randomized at a 2:1 ratio to either the intervention (n = 19; mobile application–based program) or control (n = 10; paper-based program) group. The mobile application delivered a personalized exercise program, which was tailored by physiotherapists based on remote monitoring of patient-reported symptoms. Feasibility outcomes included retention, adherence, and satisfaction rates, as well as safety. Preliminary clinical outcomes included changes from baseline to 6 weeks in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total score, Numeric Rating Scale (NRS) pain, and other functional measures.

Results:

Twenty-six participants (16 intervention, 10 control) completed the 6-week assessment, with retention rates of 84.2% and 100%, respectively. No adverse events were reported. Adherence was high in the intervention group, with 68.7% exercising ≥5 days per week and 87.5% reporting high satisfaction. The intervention group exhibited significant reductions in the WOMAC total score (median change: −11.00; 95% confidence interval [CI]: −23.00 to −2.50; P=.01) and NRS pain score (mean change: −2.12; 95% CI: −3.13 to −1.11; P<.001).

Conclusions:

The mobile application–based personalized exercise program was feasible, safe, and well-accepted among elderly patients with knee OA. High adherence and satisfaction support the practicality of this approach, and preliminary improvements in pain and function suggest potential clinical benefit. A larger, adequately powered trial is warranted to confirm effectiveness of digital self-exercise interventions for knee OA management. Clinical Trial: ClinicalTrials.gov NCT05197010; https://www.clinicaltrials.gov/study/NCT05197010