Dittrich Florian, Back David Alexander, Harren Anna Katharina, Jäger Marcus, Landgraeber Stefan, Reinecke Felix, Beck Sascha
Department for Orthopaedics and Orthopaedic Surgery, Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg, Germany.
Clinic of Traumatology and Orthopedics, Bundeswehr Hospital Berlin, Berlin, Germany.
JMIR Mhealth Uhealth. 2020 Feb 26;8(2):e16403. doi: 10.2196/16403.
Ankle sprains are one of the most frequent sports injuries. With respect to the high prevalence of ankle ligament injuries and patients' young age, optimizing treatment and rehabilitation is mandatory to prevent future complications such as chronic ankle instability or osteoarthritis.
In modern times, an increasing amount of smartphone usage in patient care is evident. Studies investigating mobile health (mHealth)-based rehabilitation programs after ankle sprains are rare. The aim of this study was to expose any issues present in the development process of a medical app as well as associated risks and chances.
The development process of the Ankle Joint App was defined in chronological order using a protocol. The app's quality was evaluated using the (user) German Mobile App Rating Scale (MARS-G) by voluntary foot and ankle surgeons (n=20) and voluntary athletes (n=20).
A multidisciplinary development team built a hybrid app with a corresponding backend structure. The app's content provides actual medical literature, training videos, and a log function. Excellent interrater reliability (interrater reliability=0.92; 95% CI 0.86-0.96) was obtained. The mean overall score for the Ankle Joint App was 4.4 (SD 0.5). The mean subjective quality scores were 3.6 (surgeons: SD 0.7) and 3.8 (athletes: SD 0.5). Behavioral change had mean scores of 4.1 (surgeons: SD 0.7) and 4.3 (athletes: SD 0.7). The medical gain value, rated by the surgeons only, was 3.9 (SD 0.6).
The data obtained demonstrate that mHealth-based rehabilitation programs might be a useful tool for patient education and collection of personal data. The achieved (user) MARS-G scores support a high quality of the tested app. Medical app development with an a priori defined target group and a precisely intended purpose, in a multidisciplinary team, is highly promising. Follow-up studies are required to obtain funded evidence for the ankle joints app's effects on economical and medical aspects in comparison with established nondigital therapy paths.
踝关节扭伤是最常见的运动损伤之一。鉴于踝关节韧带损伤的高发病率以及患者的年轻年龄，优化治疗和康复对于预防未来并发症（如慢性踝关节不稳或骨关节炎）至关重要。
在现代，患者护理中智能手机的使用量日益增加。针对踝关节扭伤后基于移动健康（mHealth）的康复计划的研究很少。本研究的目的是揭示一款医疗应用程序开发过程中存在的任何问题以及相关风险和机遇。
使用协议按时间顺序定义踝关节应用程序的开发过程。由志愿足踝外科医生（n = 20）和志愿运动员（n = 20）使用（用户）德国移动应用评分量表（MARS - G）对该应用程序的质量进行评估。
一个多学科开发团队构建了一个具有相应后端结构的混合应用程序。该应用程序的内容提供了实际医学文献、训练视频和日志功能。获得了出色的评分者间信度（评分者间信度 = 0.92；95% CI 0.86 - 0.96）。踝关节应用程序的平均总体评分为4.4（标准差0.5）。主观质量平均评分为3.6（外科医生：标准差0.7）和3.8（运动员：标准差0.5）。行为改变的平均评分为4.1（外科医生：标准差0.7）和4.3（运动员：标准差0.7）。仅由外科医生评定的医学增益值为3.9（标准差0.6）。
所获得的数据表明，基于mHealth的康复计划可能是患者教育和个人数据收集的有用工具。所取得的（用户）MARS - G评分支持所测试应用程序的高质量。在多学科团队中，针对先验定义的目标群体和精确预期目的进行医疗应用程序开发具有很大前景。需要进行后续研究，以获得与既定非数字治疗途径相比，踝关节应用程序在经济和医学方面效果的资助证据。
