Bak Jonas, Thorborg Kristian, Clausen Mikkel Bek, Johannsen Finn Elkjær, Kirk Jeanette Wassar, Bandholm Thomas
Department of Clinical Research, Copenhagen University Hospital, Amager and Hvidovre, Copenhagen, Denmark.
Department of Orthopedic Surgery, Copenhagen University Hospital, Amager and Hvidovre, Copenhagen, Denmark.
PLOS Digit Health. 2023 May 15;2(5):e0000221. doi: 10.1371/journal.pdig.0000221. eCollection 2023 May.
Acute lateral ankle sprains (LAS) account for 4-5% of all Emergency Department (ED) visits. Few patients receive the recommended care of exercise rehabilitation. A simple solution is an exercise app for mobile devices, which can deliver tailored and real-time adaptive exercise programs.
The purpose of this pilot study was to investigate the use and preliminary effect of an app-based exercise program in patients with LAS seen in the Emergency Department at a public hospital.
We used an app that delivers evidence-based exercise rehabilitation for LAS using algorithm-controlled progression. Participants were recruited from the ED and followed for four months. Data on app-use and preliminary effect were collected continuously through the exercise app and weekly text-messages. Baseline and follow-up data were collected though an online questionnaire. Semi-structured interviews were performed after participants stopped using the app. Results: Health care professionals provided 485 patients with study information and exercise equipment. Of those, 60 participants chose to enroll in the study and 43 became active users. The active users completed a median of 7 exercise sessions. Most of the active users were very satisfied or satisfied (79%-93%) with the app and 95.7% would recommend it to others. The interviews showed that ankle sprains were considered an innocuous injury that would recover by itself. Several app users expressed they felt insufficiently informed from the ED health care professionals. Only 39% felt recovered when they stopped exercising, and 33% experienced a recurrent sprain in the study period. Conclusion: In this study, only few patients with LAS became active app users after receiving information in the ED about a free app-based rehabilitation program. We speculate the reason for this could be the perception that LAS is an innocuous injury. Most of the patients starting training were satisfied with the app, although few completed enough exercise sessions to realistically impact clinical recovery. Interestingly more than half of the participants did not feel fully recovered when they stopped exercising and one third experienced a recurrent sprain.
TRIAL-IDENTIFIERS: https://clinicaltrials.gov/ct2/show/NCT03550274, preprint (open access): https://www.medrxiv.org/content/10.1101/2022.01.31.22269313v1.
急性外侧踝关节扭伤（LAS）占急诊科（ED）就诊人数的4%-5%。很少有患者接受推荐的运动康复治疗。一个简单的解决方案是为移动设备开发一款运动应用程序，它可以提供量身定制的实时自适应运动计划。
本试点研究的目的是调查一款基于应用程序的运动计划在一家公立医院急诊科就诊的LAS患者中的使用情况和初步效果。
我们使用了一款应用程序，该程序利用算法控制的进展为LAS提供循证运动康复治疗。参与者从急诊科招募，并随访四个月。通过运动应用程序和每周短信持续收集关于应用程序使用情况和初步效果的数据。通过在线问卷收集基线和随访数据。在参与者停止使用应用程序后进行半结构化访谈。结果：医护人员向485名患者提供了研究信息和运动设备。其中，60名参与者选择参加研究，43名成为活跃用户。活跃用户完成的运动课程中位数为7节。大多数活跃用户对该应用程序非常满意或满意（79%-93%），95.7%的用户会向他人推荐。访谈表明，踝关节扭伤被认为是一种无害的损伤，会自行恢复。几位应用程序用户表示，他们觉得急诊科医护人员提供的信息不足。在停止锻炼时，只有39%的用户感觉恢复了，33%的用户在研究期间经历了复发性扭伤。结论：在本研究中，在急诊科得知有一款免费的基于应用程序的康复计划后，只有少数LAS患者成为活跃的应用程序用户。我们推测其原因可能是认为LAS是一种无害的损伤。大多数开始训练的患者对该应用程序感到满意，尽管很少有人完成足够的运动课程以切实影响临床恢复。有趣的是，超过一半 的参与者在停止锻炼时感觉没有完全恢复，三分之一的人经历了复发性扭伤。
https://clinicaltrials.gov/ct2/show/NCT03550274，预印本（开放获取）：https://www.medrxiv.org/content/10.1101/2022. .01.31.22269313v1。
