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开发一款移动应用程序以提高膝骨关节炎患者的运动准确性和生活质量:一项随机对照试验。

Development of a mobile application to improve exercise accuracy and quality of life in knee osteoarthritis patients: a randomized controlled trial.

机构信息

Department of Orthopaedics, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, 681 Samsen Rd, Bangkok, 10300, Dusit, Thailand.

Hematology and Oncology Department, Boston Children's Hospital, Boston, MA, USA.

出版信息

Arch Orthop Trauma Surg. 2023 Feb;143(2):729-738. doi: 10.1007/s00402-021-04149-8. Epub 2021 Aug 28.

Abstract

INTRODUCTION

Knee Osteoarthritis (OA) is a degenerative joint disease that needs consistent exercise and an accurate understanding of the condition for long-term maintenance. While the accessibility of outpatient care is essential for disease management, many patients lack the resources to receive adequate healthcare. To address this challenge, we developed a not-for-profit interactive mobile application that provides a disease-specific educational background and a structured exercise regimen to patients.

MATERIAL AND METHODS

"Rak Kao" (English translation: Love-Your-Knee) mobile application was designed to analyze the questionnaire data to assess the stage of knee OA and generate a personalized recommendation of treatment and exercise type using rule-based and Artificial Intelligence (AI) techniques. A single-blinded study was conducted with patients (n = 82) who were randomly assigned to the mobile application group (M-group) and the handout group (H-group). Patient groups were controlled for age, gender, BMI, onset of pain, grade of disease, education level, and occupation. Accuracy in performance of three prescribed knee exercises (catch-bend-down, stretch-touch-feet, and sit-stretch-hold) was evaluated. Clinical outcomes were evaluated before and after the 4-weeks program to assess the range of motion, symptoms, pain, physical activity, and quality of life via the KOOS and KSS scores.

RESULTS

Completion of the study led to significantly more overall exercise accuracy in the M-group (76.2%) than the H-group (52.5%). Activities of daily life, quality of life, ability to do sports and recreational activities were significantly more improved in the M-group than the H-group (p < .01). No difference in the range of motion between groups. Satisfaction of patients' experience was higher in the M-group than the H-group (p = .001) after the 4-week regimen.

CONCLUSIONS

With the better accuracy and outcomes for rehabilitation in the M-group than the H-group, we strongly recommend using our mobile application as a better alternative than handouts for exercises and information for patients with knee OA.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT03666585.

摘要

简介

膝关节骨关节炎(OA)是一种退行性关节疾病,需要持续运动,并准确了解病情,以进行长期维持。虽然门诊护理的可及性对疾病管理至关重要,但许多患者缺乏获得足够医疗保健的资源。为了解决这一挑战,我们开发了一个非营利性的互动移动应用程序,为患者提供疾病特定的教育背景和结构化的运动方案。

材料和方法

“Rak Kao”(英文翻译:Love-Your-Knee)移动应用程序旨在分析问卷数据,以评估膝关节 OA 的阶段,并使用基于规则和人工智能(AI)技术生成个性化的治疗和运动类型建议。对 82 名患者进行了单盲研究,他们被随机分配到移动应用程序组(M 组)和手册组(H 组)。对患者组进行了年龄、性别、BMI、疼痛发作、疾病程度、教育水平和职业的控制。评估了三个规定的膝关节运动(catch-bend-down、stretch-touch-feet 和 sit-stretch-hold)的执行准确性。在 4 周方案前后评估临床结果,通过 KOOS 和 KSS 评分评估运动范围、症状、疼痛、身体活动和生活质量。

结果

完成研究后,M 组的整体运动准确性明显高于 H 组(76.2%比 52.5%)。与 H 组相比,M 组的日常生活活动、生活质量、运动和娱乐活动能力显著改善(p<.01)。两组间运动范围无差异。4 周方案后,M 组患者对体验的满意度高于 H 组(p=.001)。

结论

与 H 组相比,M 组在康复方面的准确性和结果更好,我们强烈建议将我们的移动应用程序作为一种更好的选择,替代膝关节 OA 患者的手册,提供运动和信息。

试验注册

ClinicalTrials.gov:NCT03666585。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51cd/8397851/37eef37592c9/402_2021_4149_Fig1_HTML.jpg

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