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Digital Versus Conventional Rehabilitation After Total Hip Arthroplasty: A Single-Center, Parallel-Group Pilot Study
BACKGROUND: The demand for total hip arthroplasty (THA) is rising. In the face of rapidly increasing health care costs, ensuring widespread, cost-effective rehabilitation is a priority. Technologies allowing independent home-based rehabilitation may be the key to facilitate access, improve effective...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
JMIR Publications
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6611148/ https://www.ncbi.nlm.nih.gov/pubmed/31228176 http://dx.doi.org/10.2196/14523 |
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author | Dias Correia, Fernando Nogueira, André Magalhães, Ivo Guimarães, Joana Moreira, Maria Barradas, Isabel Molinos, Maria Teixeira, Laetitia Pires, Joaquim Seabra, Rosmaninho Lains, Jorge Bento, Virgílio |
author_facet | Dias Correia, Fernando Nogueira, André Magalhães, Ivo Guimarães, Joana Moreira, Maria Barradas, Isabel Molinos, Maria Teixeira, Laetitia Pires, Joaquim Seabra, Rosmaninho Lains, Jorge Bento, Virgílio |
author_sort | Dias Correia, Fernando |
collection | PubMed |
description | BACKGROUND: The demand for total hip arthroplasty (THA) is rising. In the face of rapidly increasing health care costs, ensuring widespread, cost-effective rehabilitation is a priority. Technologies allowing independent home-based rehabilitation may be the key to facilitate access, improve effectiveness, and lower costs of care. OBJECTIVE: The aim of this study was to assess the feasibility of a novel artificial intelligence–powered digital biofeedback system following THA and compare the clinical outcomes against supervised conventional rehabilitation. METHODS: This was a single-center, parallel-group pilot study, with an 8-week intervention program. Patients were assessed at baseline, during the program (at 4 and 8 weeks), and 3 and 6 months after surgery. The primary outcome was the Timed Up and Go (TUG) score and secondary outcomes were the Hip dysfunction and Osteoarthritis Outcome Scale (HOOS; a patient-reported outcome) and hip range of motion (ROM). RESULTS: A total of 66 patients were included: 35 digital physiotherapy (PT) versus 31 conventional. There were no differences at baseline between groups except for lower HOOS quality of life (QoL) subscale scores in the digital PT group. Clinically relevant improvements were noted in both groups at all time points. The digital PT group showed a retention rate of 86% (30/35). Per-protocol analysis revealed a superiority of the digital PT group for all outcome measures. Intention-to-treat analysis revealed the superiority of the digital PT group at all time points for TUG (change between baseline and 4 and 8 weeks: P<.001; change between baseline and 3 and 6 months: P=.001 and P=.005, respectively), with a difference between median changes of −4.79 seconds (95% CI −7.24 to −1.71) at 6 months post-THA. Between baseline and month 6, results were also superior in the digital PT group for the HOOS sports and QoL subscales and all ROM except for standing flexion. CONCLUSIONS: This study demonstrates this novel solution holds promise in rehabilitation after THA, ensuring better clinical outcomes than conventional rehabilitation while reducing dependence on human resources. TRIAL REGISTRATION: ClinicalTrials.gov NCT03045549; https://clinicaltrials.gov/ct2/show/NCT03045549 |
format | Online Article Text |
id | pubmed-6611148 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | JMIR Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-66111482019-07-26 Digital Versus Conventional Rehabilitation After Total Hip Arthroplasty: A Single-Center, Parallel-Group Pilot Study Dias Correia, Fernando Nogueira, André Magalhães, Ivo Guimarães, Joana Moreira, Maria Barradas, Isabel Molinos, Maria Teixeira, Laetitia Pires, Joaquim Seabra, Rosmaninho Lains, Jorge Bento, Virgílio JMIR Rehabil Assist Technol Original Paper BACKGROUND: The demand for total hip arthroplasty (THA) is rising. In the face of rapidly increasing health care costs, ensuring widespread, cost-effective rehabilitation is a priority. Technologies allowing independent home-based rehabilitation may be the key to facilitate access, improve effectiveness, and lower costs of care. OBJECTIVE: The aim of this study was to assess the feasibility of a novel artificial intelligence–powered digital biofeedback system following THA and compare the clinical outcomes against supervised conventional rehabilitation. METHODS: This was a single-center, parallel-group pilot study, with an 8-week intervention program. Patients were assessed at baseline, during the program (at 4 and 8 weeks), and 3 and 6 months after surgery. The primary outcome was the Timed Up and Go (TUG) score and secondary outcomes were the Hip dysfunction and Osteoarthritis Outcome Scale (HOOS; a patient-reported outcome) and hip range of motion (ROM). RESULTS: A total of 66 patients were included: 35 digital physiotherapy (PT) versus 31 conventional. There were no differences at baseline between groups except for lower HOOS quality of life (QoL) subscale scores in the digital PT group. Clinically relevant improvements were noted in both groups at all time points. The digital PT group showed a retention rate of 86% (30/35). Per-protocol analysis revealed a superiority of the digital PT group for all outcome measures. Intention-to-treat analysis revealed the superiority of the digital PT group at all time points for TUG (change between baseline and 4 and 8 weeks: P<.001; change between baseline and 3 and 6 months: P=.001 and P=.005, respectively), with a difference between median changes of −4.79 seconds (95% CI −7.24 to −1.71) at 6 months post-THA. Between baseline and month 6, results were also superior in the digital PT group for the HOOS sports and QoL subscales and all ROM except for standing flexion. CONCLUSIONS: This study demonstrates this novel solution holds promise in rehabilitation after THA, ensuring better clinical outcomes than conventional rehabilitation while reducing dependence on human resources. TRIAL REGISTRATION: ClinicalTrials.gov NCT03045549; https://clinicaltrials.gov/ct2/show/NCT03045549 JMIR Publications 2019-06-21 /pmc/articles/PMC6611148/ /pubmed/31228176 http://dx.doi.org/10.2196/14523 Text en ©Fernando Dias Correia, André Nogueira, Ivo Magalhães, Joana Guimarães, Maria Moreira, Isabel Barradas, Maria Molinos, Laetitia Teixeira, Joaquim Pires, Rosmaninho Seabra, Jorge Lains, Virgílio Bento. Originally published in JMIR Rehabilitation and Assistive Technology (http://rehab.jmir.org), 21.06.2019. https://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Rehabilitation and Assistive Technology, is properly cited. The complete bibliographic information, a link to the original publication on http://rehab.jmir.org/, as well as this copyright and license information must be included. |
spellingShingle | Original Paper Dias Correia, Fernando Nogueira, André Magalhães, Ivo Guimarães, Joana Moreira, Maria Barradas, Isabel Molinos, Maria Teixeira, Laetitia Pires, Joaquim Seabra, Rosmaninho Lains, Jorge Bento, Virgílio Digital Versus Conventional Rehabilitation After Total Hip Arthroplasty: A Single-Center, Parallel-Group Pilot Study |
title | Digital Versus Conventional Rehabilitation After Total Hip Arthroplasty: A Single-Center, Parallel-Group Pilot Study |
title_full | Digital Versus Conventional Rehabilitation After Total Hip Arthroplasty: A Single-Center, Parallel-Group Pilot Study |
title_fullStr | Digital Versus Conventional Rehabilitation After Total Hip Arthroplasty: A Single-Center, Parallel-Group Pilot Study |
title_full_unstemmed | Digital Versus Conventional Rehabilitation After Total Hip Arthroplasty: A Single-Center, Parallel-Group Pilot Study |
title_short | Digital Versus Conventional Rehabilitation After Total Hip Arthroplasty: A Single-Center, Parallel-Group Pilot Study |
title_sort | digital versus conventional rehabilitation after total hip arthroplasty: a single-center, parallel-group pilot study |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6611148/ https://www.ncbi.nlm.nih.gov/pubmed/31228176 http://dx.doi.org/10.2196/14523 |
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