Abstract
BackgroundRecent developments in technology are promising for providing home-based exercise programs.ObjectiveThe objective of this study was to evaluate the feasibility and patient experience of a home-based rehabilitation program after total hip arthroplasty (THA) delivered using videos on a tablet personal computer (PC) and a necklace-worn motion sensor to continuously monitor mobility-related activities.MethodsWe enrolled 30 independently living patients aged 18-75 years who had undergone THA as a treatment for primary or secondary osteoarthritis (OA) between December 2015 and February 2017. Patients followed a 12-week exercise program with video instructions on a tablet PC and daily physical activity registration through a motion sensor. Patients were asked to do strengthening and walking exercises at least 5 days a week. There was weekly phone contact with a physiotherapist. Adherence and technical problems were recorded during the intervention. User evaluation was done in week 4 (T1) and at the end of the program (T2).ResultsOverall, 26 patients completed the program. Average adherence for exercising 5 times a week was 92%. Reasons mentioned most often for nonadherence were vacation or a day or weekend off 25% (33/134) and work 15% (20/134). The total number of technical issues was 8. The average score on the user evaluation questionnaire (range 0-5) was 4.6 at T1 and 4.5 at T2. The highest score was for the subscale “coaching” and the lowest for the subscale “sensor.”ConclusionsA home-based rehabilitation program driven by a tablet app and mobility monitoring seems feasible for THA patients. Adherence was good and patient experience was positive. The novel technology was well accepted. When the home-based rehabilitation program proves to be effective, it could be used as an alternative to formal physiotherapy. However, further research on its effectiveness is needed.
Highlights
Surgical treatment by means of total hip arthroplasty (THA) is most often indicated in end-stage hip osteoarthritis (OA)
A home-based rehabilitation program driven by a tablet app and mobility monitoring seems feasible for THA patients
When the home-based rehabilitation program proves to be effective, it could be used as an alternative to formal physiotherapy
Summary
Surgical treatment by means of total hip arthroplasty (THA) is most often indicated in end-stage hip osteoarthritis (OA). A total of 29,937 primary THAs were performed in the Netherlands in 2017 [1]. Postoperative physiotherapy is not always covered by the basic health insurance in the Netherlands [2]. This can lead to suboptimal recovery [3]. Austin et al showed that this physiotherapy need not take place in a formal setting; a home-based program could work as well [4]. Austin et al showed that a home-based rehabilitation program seems to be both safe and efficacious for a majority of patients undergoing THA [4]. Recent developments in technology are promising for providing home-based exercise programs
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