Effect of mobile application rehabilitation guidance on patients after total knee arthroplasty

doi:10.3877/cma.j.issn.1674-134X.2021.05.005

Abstract

Abstract:

Objective

To study the impact of remote postoperative rehabilitation guidance and follow-up based on the smartphone application (APP) on lower extremity pain, physical function and motor function performance in patients undergoing total knee arthroplasty.

Methods

The patients who underwent total knee arthroplasty due to knee osteoarthritis were recruited from the Joint Surgery Department of the First Affiliated Hospital of Sun Yat-sen University between March 2019 to October 2019. The patients with secondary arthritis and severe underlying disease or mental diseases were excluded. The patients were randomly divided into two groups by random number table. During the follow-up, the intervention group conducted rehabilitation guidance and follow-up through the smartphone APP after discharge while the control group underwent traditional home rehabilitation training instructed by doctors. After six months of follow-up, visual analog scale (VAS) of pain, Western Ontario and McMaster university osteoarthritis index scale (WOMAC), Time-up-and-go test(TUG), single leg stance test (SLS) and adherence scores were compared. The t test and rank sum test were used for statistical analysis.

Results

A total of 60 patients were analyzed with 30 in each group. The VAS score and total WOMAC score, TUG and SLS test time and adherence score of the intervention group were better than those of the control group (t=2.37, P<0.05; t=2.566, P<0.05 ; Z=-3.507, P<0.05; t=-2.632, P<0.05). Among them, after six months of follow-up, the VAS scores in the intervention group and the control group were (1.7±1.1) points and (2.5±1.3) points; WOMAC total scores were (15.4±8.4) and (21.2±8.9) points; TUG test time were 8.8 (8.0, 12.3) seconds and 12.00(10.0, 15.0) seconds; SLS test time were (13.9±8.8) seconds and (8.4±4.4) seconds respectively; adherence scores were (40.3±6.1) points and (30.9±9.6) points, respectively. However, the difference between the scores of pain items and physical function items of the WOMAC scale were statistically significant (t=2.472, P<0.05; t=2.327, P<0.05).

Conclusions

Based on the smartphone APP for home rehabilitation training guidance and follow-up, patients have higher exercise adherence and better recovery effects. In the future, technological products continue to introduce and it has broad application prospects and is worthy of further promotion.

Key words: Arthroplasty, replacement, knee, Mobile applications, Exercise therapy, Patient compliance

Wenchang Li, Kangping Song, Tianwen Huang, Xiaoling Chen, Qiaoli Liu, Long Zhao, Yangyang Lin, Weiming Liao, Peihui Wu. Effect of mobile application rehabilitation guidance on patients after total knee arthroplasty[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2021, 15(05): 547-553.

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References 28

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基本资料		干预组	对照组	统计值	P值
例数		30	30
性别(例)
	男	7	5	t＝0.417	>0.05
	女	23	25	t＝0.417	>0.05
年龄[岁，(±s)]		66.2±6.7	67.3±8.0	t＝-0.594	>0.05
身高[cm，(±s)]		158.5±6.0	157.3±7.0	t＝0.734	>0.05
体重[kg，(±s)]		64.8±9.7	61.8±10.1	t＝1.208	>0.05
BMI [kg/m²，(±s)]		25.8±3.3	24.9±2.9	t＝1.145	>0.05
手术时间[min，(±s)]		107.3±7.1	108.8±7.3	t＝-0.838	>0.05
出血量[ml，(±s)]		318.8±73.8	316.1±58.3	t＝0.156	>0.05
手术侧(例)				χ²＝0.069	>0.05
左		12	13	χ²＝0.069	>0.05
右		18	17	χ²＝0.069	>0.05

基本资料		干预组	对照组	统计值	P值
例数		30	30
性别(例)
	男	7	5	t＝0.417	>0.05
	女	23	25	t＝0.417	>0.05
年龄[岁，(±s)]		66.2±6.7	67.3±8.0	t＝-0.594	>0.05
身高[cm，(±s)]		158.5±6.0	157.3±7.0	t＝0.734	>0.05
体重[kg，(±s)]		64.8±9.7	61.8±10.1	t＝1.208	>0.05
BMI [kg/m²，(±s)]		25.8±3.3	24.9±2.9	t＝1.145	>0.05
手术时间[min，(±s)]		107.3±7.1	108.8±7.3	t＝-0.838	>0.05
出血量[ml，(±s)]		318.8±73.8	316.1±58.3	t＝0.156	>0.05
手术侧(例)				χ²＝0.069	>0.05
左		12	13	χ²＝0.069	>0.05
右		18	17	χ²＝0.069	>0.05

组别	例数	术前	干预后	t值	P值
干预组	30	6.1±1.0	1.7±1.1	17.07	<0.001
对照组	30	6.6±1.3	2.5±1.3	11.76	<0.001
t值		1.69	2.37
P值		>0.05	0.021

组别	例数	术前	干预后	t值	P值
干预组	30	6.1±1.0	1.7±1.1	17.07	<0.001
对照组	30	6.6±1.3	2.5±1.3	11.76	<0.001
t值		1.69	2.37
P值		>0.05	0.021

组别	例数	WOMAC总分(±s)		疼痛评分(±s)		僵硬评分M(P₂₅，P₇₅)		日常功能活动评分M(P₂₅，P₇₅)
组别	例数	术前	干预后	术前	干预后	术前	干预后	术前	干预后
干预组	30	56.9±10.9	15.4±8.4	12.9±2.6	3.3±2.0	2.0(1.0，2.0)	1.0(0，2.0)	41.0(34.0，51.3)	9.0(7.0，14.3)
对照组	30	59.5±12.4	21.2±8.9	13.9±3.0	4.8±2.8	2.0(1.0，2.0)	1.0(0.8，2.0)	43.5(34.0，51.8)	13.0(9.0，20.0)
统计值		t＝0.872	t＝2.566	t＝1.341	t＝2.472	Z＝-0.440	Z＝-0.529	Z＝-0.548	Z＝-2.327
P值		>0.05	0.013	>0.05	0.016	>0.05	>0.05	>0.05	0.020

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