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Applications of Digital Health Technologies in Knee Osteoarthritis: Narrative Review

BACKGROUND: With the increasing adoption of high-speed internet and mobile technologies by older adults, digital health is a promising modality to enhance clinical care for people with knee osteoarthritis (KOA), including those with knee replacement (KR). OBJECTIVE: This study aimed to summarize the...

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Detalles Bibliográficos
Autores principales: Shah, Nirali, Costello, Kerry, Mehta, Akshat, Kumar, Deepak
Formato: Online Artículo Texto
Lenguaje:English
Publicado: JMIR Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9218886/
https://www.ncbi.nlm.nih.gov/pubmed/35675102
http://dx.doi.org/10.2196/33489
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author Shah, Nirali
Costello, Kerry
Mehta, Akshat
Kumar, Deepak
author_facet Shah, Nirali
Costello, Kerry
Mehta, Akshat
Kumar, Deepak
author_sort Shah, Nirali
collection PubMed
description BACKGROUND: With the increasing adoption of high-speed internet and mobile technologies by older adults, digital health is a promising modality to enhance clinical care for people with knee osteoarthritis (KOA), including those with knee replacement (KR). OBJECTIVE: This study aimed to summarize the current use, cost-effectiveness, and patient and clinician perspectives of digital health for intervention delivery in KOA and KR. METHODS: In this narrative review, search terms such as mobile health, smartphone, mobile application, mobile technology, ehealth, text message, internet, knee osteoarthritis, total knee arthroplasty, and knee replacement were used in the PubMed and Embase databases between October 2018 and February 2021. The search was limited to original articles published in the English language within the past 10 years. In total, 91 studies were included. RESULTS: Digital health technologies such as websites, mobile apps, telephone calls, SMS text messaging, social media, videoconferencing, and custom multi-technology systems have been used to deliver interventions in KOA and KR populations. Overall, there was significant heterogeneity in the types and applications of digital health used in these populations. Digital patient education improved disease-related knowledge, especially when used as an adjunct to traditional methods of patient education for both KOA and KR. Digital health that incorporated person-specific motivational messages, biofeedback, or patient monitoring was more successful at improving physical activity than self-directed digital interventions for both KOA and KR. Many digital exercise interventions were found to be as effective as in-person physical therapy for people with KOA. Many digital exercise interventions for KR incorporated both in-person and web-based treatments (blended format), communication with clinicians, and multi-technology systems and were successful in improving knee range of motion and self-reported symptoms and reducing the length of hospital stays. All digital interventions that incorporated cognitive behavioral therapy or similar psychological interventions showed significant improvements in knee pain, function, and psychological health when compared with no treatment or traditional treatments for both KOA and KR. Although limited in number, studies have indicated that digital health may be cost-effective for these populations, especially when travel costs are considered. Finally, although patients with KOA and KR and clinicians had positive views on digital health, concerns related to privacy and security and concerns related to logistics and training were raised by patients and clinicians, respectively. CONCLUSIONS: For people with KOA and KR, many studies found digital health to be as effective as traditional treatments for patient education, physical activity, and exercise interventions. All digital interventions that incorporated cognitive behavioral therapy or similar psychological treatments were reported to result in significant improvements in patients with KOA and KR when compared with no treatment or traditional treatments. Overall, technologies that were blended and incorporated communication with clinicians, as well as biofeedback or patient monitoring, showed favorable outcomes.
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spelling pubmed-92188862022-06-24 Applications of Digital Health Technologies in Knee Osteoarthritis: Narrative Review Shah, Nirali Costello, Kerry Mehta, Akshat Kumar, Deepak JMIR Rehabil Assist Technol Review BACKGROUND: With the increasing adoption of high-speed internet and mobile technologies by older adults, digital health is a promising modality to enhance clinical care for people with knee osteoarthritis (KOA), including those with knee replacement (KR). OBJECTIVE: This study aimed to summarize the current use, cost-effectiveness, and patient and clinician perspectives of digital health for intervention delivery in KOA and KR. METHODS: In this narrative review, search terms such as mobile health, smartphone, mobile application, mobile technology, ehealth, text message, internet, knee osteoarthritis, total knee arthroplasty, and knee replacement were used in the PubMed and Embase databases between October 2018 and February 2021. The search was limited to original articles published in the English language within the past 10 years. In total, 91 studies were included. RESULTS: Digital health technologies such as websites, mobile apps, telephone calls, SMS text messaging, social media, videoconferencing, and custom multi-technology systems have been used to deliver interventions in KOA and KR populations. Overall, there was significant heterogeneity in the types and applications of digital health used in these populations. Digital patient education improved disease-related knowledge, especially when used as an adjunct to traditional methods of patient education for both KOA and KR. Digital health that incorporated person-specific motivational messages, biofeedback, or patient monitoring was more successful at improving physical activity than self-directed digital interventions for both KOA and KR. Many digital exercise interventions were found to be as effective as in-person physical therapy for people with KOA. Many digital exercise interventions for KR incorporated both in-person and web-based treatments (blended format), communication with clinicians, and multi-technology systems and were successful in improving knee range of motion and self-reported symptoms and reducing the length of hospital stays. All digital interventions that incorporated cognitive behavioral therapy or similar psychological interventions showed significant improvements in knee pain, function, and psychological health when compared with no treatment or traditional treatments for both KOA and KR. Although limited in number, studies have indicated that digital health may be cost-effective for these populations, especially when travel costs are considered. Finally, although patients with KOA and KR and clinicians had positive views on digital health, concerns related to privacy and security and concerns related to logistics and training were raised by patients and clinicians, respectively. CONCLUSIONS: For people with KOA and KR, many studies found digital health to be as effective as traditional treatments for patient education, physical activity, and exercise interventions. All digital interventions that incorporated cognitive behavioral therapy or similar psychological treatments were reported to result in significant improvements in patients with KOA and KR when compared with no treatment or traditional treatments. Overall, technologies that were blended and incorporated communication with clinicians, as well as biofeedback or patient monitoring, showed favorable outcomes. JMIR Publications 2022-06-08 /pmc/articles/PMC9218886/ /pubmed/35675102 http://dx.doi.org/10.2196/33489 Text en ©Nirali Shah, Kerry Costello, Akshat Mehta, Deepak Kumar. Originally published in JMIR Rehabilitation and Assistive Technology (https://rehab.jmir.org), 08.06.2022. 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 https://rehab.jmir.org/, as well as this copyright and license information must be included.
spellingShingle Review
Shah, Nirali
Costello, Kerry
Mehta, Akshat
Kumar, Deepak
Applications of Digital Health Technologies in Knee Osteoarthritis: Narrative Review
title Applications of Digital Health Technologies in Knee Osteoarthritis: Narrative Review
title_full Applications of Digital Health Technologies in Knee Osteoarthritis: Narrative Review
title_fullStr Applications of Digital Health Technologies in Knee Osteoarthritis: Narrative Review
title_full_unstemmed Applications of Digital Health Technologies in Knee Osteoarthritis: Narrative Review
title_short Applications of Digital Health Technologies in Knee Osteoarthritis: Narrative Review
title_sort applications of digital health technologies in knee osteoarthritis: narrative review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9218886/
https://www.ncbi.nlm.nih.gov/pubmed/35675102
http://dx.doi.org/10.2196/33489
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