Previously submitted to: Journal of Medical Internet Research (no longer under consideration since Dec 12, 2025)
Date Submitted: Apr 6, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Digital physiotherapeutic elbow-specific training system for patients after arthroscopic release of elbow contracture: A noninferiority randomized controlled trial.
ABSTRACT
Background:
The effectiveness of a digital training system in which patients receive individually tailored physiotherapeutic elbow-specific training (PEST) delivered via a digital training system is unclear.
Objective:
To determine the effectiveness of a digital training system in which patients receive individually tailored PEST supervision and guidance via the Joymotion intelligent Rehabilitation System and educational videos compared with conventional training conducted by qualified physiotherapists at outpatient clinics and unsupervised home-based PEST training in patients following arthroscopic release for post-traumatic elbow stiffness.
Methods:
This single-center, non-inferiority randomized controlled trial was conducted at the Rehabilitation Department of Shanghai Sixth People’s Hospital between September 2020 and June 2024. Patients aged 16–65 undergoing arthroscopic release for post-traumatic elbow stiffness were randomized to receive either a 12-week digital training program, or conventional outpatient clinic-based training. Outcome measures included elbow flexion–extension range of motion (primary outcome), forearm rotation, isometric and dynamic muscle strength, ASES and DASH scores, EQ-5D-5L, cost-effectiveness, adherence, and adverse events, assessed at 4, 12, and 24 weeks postoperatively.
Results:
At 12 weeks, the digital training (DT) group achieved elbow flexion–extension range of motion that was non-inferior to the conventional training (CT) group, with between-group differences remaining within the predefined 10° margin. Secondary outcomes, including forearm rotation, muscle strength, functional scores, and quality of life, were comparable between groups. Telerehabilitation incurred significantly lower total costs per patient and demonstrated high adherence and patient satisfaction, with a safety profile similar to conventional rehabilitation.
Conclusions:
Individually tailored physiotherapeutic elbow-specific training via a digital training system is a viable, cost-effective, and safe alternative to conventional outpatient clinic-based training following arthroscopic release for post-traumatic elbow stiffness. These findings support its integration into routine post-surgical care, particularly for patients facing barriers to traditional therapy. Clinical Trial: This study was registered in Chinese Clinical Trial Registry (https://www.chictr.org.cn/) Trial registration number: Chictr2400093415
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