Digital Versus Conventional Rehabilitation After Total Hip Arthroplasty: A Single-Center, Parallel-Group Pilot Study

Overview

Journal JMIR Rehabil Assist Technol

Publisher JMIR Publications

Date 2019 Jun 23

PMID 31228176

Citations 27

Authors

Fernando Dias Correia

Andre Nogueira

Ivo Magalhaes

Joana Guimaraes

Maria Moreira

Isabel Barradas

Maria Molinos

Laetitia Teixeira

Joaquim Pires

Rosmaninho Seabra

Jorge Lains

Virgilio Bento

Affiliations

Soon will be listed here.

Abstract

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.

Citing Articles

Research Progress and Hot Topics in Telerehabilitation for Hip or Knee Arthroplasty.

Wang L, Zhang L, He C Orthop Surg. 2025; 17(3):677-693.

PMID: 39757734 PMC: 11872367. DOI: 10.1111/os.14347.

Patient Engagement in a Mobile App-Based Rehabilitation Program for Total Hip or Knee Arthroplasty: Secondary Data Analysis of a Randomized Controlled Trial.

Wang Q, Lee R, Hunter S, Zhu A, Chan S JMIR Mhealth Uhealth. 2024; 12:e57635.

PMID: 39353187 PMC: 11480718. DOI: 10.2196/57635.

Delivery of Allied Health Interventions Using Telehealth Modalities: A Rapid Systematic Review of Randomized Controlled Trials.

Raymond M, Christie L, Kramer S, Malaguti C, Mok Z, Gardner B Healthcare (Basel). 2024; 12(12).

PMID: 38921331 PMC: 11203162. DOI: 10.3390/healthcare12121217.

Patients' needs and experiences of telerehabilitation after total hip and knee arthroplasty: A qualitative systematic review and meta-synthesis.

Zhang W, Ji H, Wu Y, Xu Z, Li J, Sun Q Digit Health. 2024; 10:20552076241256756.

PMID: 38846364 PMC: 11155359. DOI: 10.1177/20552076241256756.

Incorporating Wearable Technology for Enhanced Rehabilitation Monitoring after Hip and Knee Replacement.

Lebleu J, Daniels K, Pauwels A, Dekimpe L, Mapinduzi J, Poilvache H Sensors (Basel). 2024; 24(4).

PMID: 38400321 PMC: 10892564. DOI: 10.3390/s24041163.

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