Prospective, Single-blind, Randomized Controlled Trial to Evaluate the Effectiveness of a Digital Exercise Therapy Application Compared With Conventional Physical Therapy for the Treatment of Nonoperative Knee Conditions

OBJECTIVE: To evaluate the effectiveness and adherence of a home exercise therapy program using a digital exercise therapy application (DETA) compared with conventional physical therapy (PT). DESIGN: Parallel group, randomized controlled trial. SETTING: Two clinics in a tertiary care academic center. PARTICIPANTS: Participants (N=60) were enrolled within 1 week after a provider visit for knee pain. Inclusion criteria: age 18-75 years, knee pain diagnosis, and clinician-prescribed PT. INTERVENTIONS: Participants were randomized to complete either an 8-week intervention of conventional PT (enrolled n=29; complete n=26) or the DETA (enrolled n=31; completed n=24). MAIN OUTCOME MEASURES: Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Interference (PI) and Physical Function (PF) scores implemented via computer adaptive tests; number of exercise sessions completed per week (adherence). RESULTS: Compared with the PT group, the DETA group reported significant decreases in PROMIS-PI scores (−6.1±6.7 vs −1.5±6.6, P<.05, d=0.78) and increases in PROMIS-PF scores (6.0±6.6 vs −0.8±5.8, P<.01, d=0.89) after 8 weeks. No group differences in adherence were observed (P>.05). CONCLUSIONS: Use of this DETA resulted in greater pain and functional improvements compared with PT, with no differences in adherence. It is possible this application may be a viable alternative to conventional PT in certain cases. A larger sample from various geographic locations is needed to improve generalizability and for subgroup analysis. Further investigation is warranted to determine the factors responsible for the differences observed between the groups.