Cooper D M, Bhuskute N, Walsh G
Centre for Health Social Care, Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, England.
Calderdale and Huddersfield NHS Foundation Trust, Huddersfield, England.
JB JS Open Access. 2022 Apr 27;7(2). doi: 10.2106/JBJS.OA.21.00154. eCollection 2022 Apr-Jun.
Knee replacement operations are common, highly successful procedures that are increasing in frequency. The COVID-19 pandemic has emphasized the need for innovative care pathways that reduce face-to-face appointments. We report on the impact of introducing a wearable sensor for pre- and postoperative rehabilitation of 21 knee replacement patients at 2 hospitals in the U.K.
The sensor (BPMpathway; 270 Vision) was provided during joint school prior to knee replacement and stayed with the patient until a maximum of 9 weeks post-surgery. Participant progress and exercise were monitored remotely, with exercise regimens altered as required. Participants and clinicians could communicate remotely via the device.
The median range of motion during the first week post-surgery was 63° (interquartile range [IQR] = 21°) and increased to 136° (IQR = 16°) by week 7. The rate of participant compliance with exercises using the device was 32.3% for thrice-daily compliance and 52.4% for once-daily compliance. The 2-way communication channel was well utilized by both participants and clinicians. We report a 35.7% reduction in face-to-face physiotherapy appointments compared with standard practice. Finally, >80% of users who completed the feedback questionnaire reported a positive experience using the device, finding it easy to understand and reporting that it motivated them to perform their exercises.
The use of BPMpathway was well received, effective, and reduced face-to-face physiotherapy appointments.
Remote monitoring can reduce the burden to the outpatient physiotherapy service by supporting the post-COVID-19 surgical service recovery plans of the National Health Service and allowing patients to recuperate at home.
膝关节置换手术是常见且成功率很高的手术,其实施频率正在增加。2019冠状病毒病疫情凸显了对创新护理途径的需求,这种途径可减少面对面预约。我们报告了在英国两家医院为21名膝关节置换患者引入可穿戴传感器用于术前和术后康复的影响。
在膝关节置换术前的联合培训期间提供该传感器(BPMpathway;270 Vision),并让患者一直使用,直至术后最多9周。远程监测参与者的进展和锻炼情况,并根据需要调整锻炼方案。参与者和临床医生可通过该设备进行远程沟通。
术后第一周的活动范围中位数为63°(四分位间距[IQR]=21°),到第7周时增加至136°(IQR = 16°)。使用该设备进行锻炼时,参与者每日三次的依从率为32.3%,每日一次的依从率为52.4%。参与者和临床医生都很好地利用了双向沟通渠道。与标准做法相比,我们报告面对面物理治疗预约减少了35.7%。最后,表示完成反馈问卷的用户中,超过80%报告使用该设备的体验良好,认为其易于理解,并表示它激励他们进行锻炼。
BPMpathway的使用受到好评,效果良好,并减少了面对面物理治疗预约。
远程监测可通过支持英国国家医疗服务体系的2019冠状病毒病后手术服务恢复计划,并让患者在家中康复,从而减轻门诊物理治疗服务的负担。