Krištof Mirt Pika, Erjavec Karmen, Krsnik Sabina, Kotnik Petra, Mohsen Hussein
General Hospital Novo Mesto, Novo Mesto, Slovenia.
Department of Physiotherapy, Faculty of Health Sciences, University of Novo Mesto, Na Loko 2, Novo Mesto, 8000, Slovenia, 386 040869839.
JMIR Rehabil Assist Technol. 2025 May 15;12:e64607. doi: 10.2196/64607.
Knee osteoarthritis (KOA) requires long-term treatment that faces significant barriers, including inadequate physiotherapy services, especially in Slovenia and comparable European countries. Mobile health apps offer a promising solution to improve accessibility and adherence to KOA treatment.
This study aimed to identify expectations of patients with KOA for app-based therapy, determine the functional requirements, and assess the main barriers and benefits of using mobile apps for KOA management. It also examined these factors about demographic data (gender, age, and education level) and motivation to perform knee exercises.
A mixed methods approach was used, integrating quantitative data from a structured questionnaire and qualitative data from in-depth interviews. The purposive sample comprised 82 patients with symptomatic KOA graded 1-3 on the Kellgren-Lawrence scale, excluding those with cognitive impairments, wheelchair dependency, significant comorbidities, or language barriers.
The analysis revealed that 53.7% (44/82) of patients preferred smartphones, while 40.2% (33/82) favored PCs for remote KOA management, citing accessibility and convenience. Exercise videos received the highest rating (µ=9.45), followed by goal setting and tracking (µ=8.95) and regular e-messages (µ=8.83). Telephone consultations with physiotherapists were also highly valued (µ=8.41). Significant differences were observed in the perceived importance of key disease information (F9=2.077; P=.04) and exercise videos (F9=2.788; P=.05) based on motivation levels but not by gender, age, or education. Perceptions of the appropriate duration of physical activity varied with motivation levels (F9=2.490; P=.02) but not with demographic factors. Men rated ease of use (4.93 vs 4.71; F1=3.961; P=.05) and the clarity of the exercise flow display higher than women. The most significant barrier was inaccurate disease information (µ=3.96), with notable differences across age groups. Younger participants (younger than 40 years) and those aged 51-60 years expressed concerns about time management and information accuracy. Patients highlighted the ability to rewatch exercises as a key app feature, while time efficiency and improved access to physiotherapists were highly valued for convenience. Enhanced communication and accurate information were essential for building trust and ensuring effective treatment.
Mobile health apps for KOA management should be designed with a user-centered approach, prioritizing accessibility, motivation, and effective communication. Key functionalities include high-quality exercise videos, goal setting, symptom tracking, and regular electronic reminders. Mitigating user-reported barriers and integrating age-specific adaptations can enhance adherence and therapeutic outcomes. The findings highlight the potential of mobile health technologies to optimize KOA self-management and improve patient quality of life, particularly in health care systems with limited physiotherapy accessibility, such as those in Slovenia.
膝关节骨关节炎（KOA）需要长期治疗，但面临诸多重大障碍，包括物理治疗服务不足，在斯洛文尼亚及类似的欧洲国家尤其如此。移动健康应用程序为改善KOA治疗的可及性和依从性提供了一个有前景的解决方案。
本研究旨在确定KOA患者对基于应用程序治疗的期望，确定功能需求，并评估使用移动应用程序管理KOA的主要障碍和益处。还研究了这些因素与人口统计学数据（性别、年龄和教育水平）以及进行膝关节锻炼的动机之间的关系。
采用混合方法，整合来自结构化问卷的定量数据和来自深入访谈的定性数据。目的样本包括82例根据凯尔格伦-劳伦斯量表分级为1-3级的症状性KOA患者，排除有认知障碍、依赖轮椅、严重合并症或语言障碍的患者。
分析显示，53.7%（44/82）的患者更喜欢使用智能手机，而40.2%（33/82）的患者因可及性和便利性而更喜欢使用个人电脑进行远程KOA管理。运动视频评分最高（µ=9.45），其次是目标设定与跟踪（µ=8.95）和定期电子信息（µ=8.83）。与物理治疗师的电话咨询也受到高度重视（µ=8.41）。基于动机水平而非性别、年龄或教育程度，在关键疾病信息（F9=2.077；P=.04）和运动视频（F9=2.788；P=.05）的感知重要性方面观察到显著差异。对体育活动适当持续时间的认知因动机水平而异（F9=2.490；P=.02），但与人口统计学因素无关。男性对易用性（4.93对4.71；F1=3.961；P=.05）和运动流程显示的清晰度的评分高于女性。最主要的障碍是疾病信息不准确（µ=3.96），不同年龄组存在显著差异。较年轻的参与者（40岁以下）和51-60岁的参与者对时间管理和信息准确性表示担忧。患者强调能够重新观看练习是应用程序的一项关键功能，而时间效率和更方便地接触物理治疗师因其便利性而受到高度重视。加强沟通和准确信息对于建立信任和确保有效治疗至关重要。
用于KOA管理的移动健康应用程序应以用户为中心进行设计，优先考虑可及性、动机和有效沟通。关键功能包括高质量的运动视频、目标设定、症状跟踪和定期电子提醒。减轻用户报告的障碍并整合针对特定年龄的调整可以提高依从性和治疗效果。研究结果突出了移动健康技术在优化KOA自我管理和改善患者生活质量方面的潜力，特别是在物理治疗可及性有限的医疗保健系统中，如斯洛文尼亚的医疗保健系统。
