Abstract
In-person home-based rehabilitation and telerehabilitation can be as effective as clinic-based rehabilitation after total knee arthroplasty (TKA), but require heavy logistics and are highly dependent on human supervision. New technologies that allow independent home-based rehabilitation without constant human supervision may help solve this problem. This was a single-center, feasibility study comparing a digital biofeedback system that meets these needs against conventional in-person home-based rehabilitation after TKA over an 8-week program. Primary outcome was the change in the Timed Up and Go score between the end of the program and baseline. Fifty-nine patients completed the study (30 experimental group; 29 conventional rehabilitation). The study demonstrated a superiority of the experimental group for all outcomes. Adverse events were similar in both groups. This is the first study to demonstrate that a digital rehabilitation solution can achieve better outcomes than conventional in-person rehabilitation, while less demanding in terms of human resources.
Highlights
total knee arthroplasty (TKA) is associated with significant pain relief, functional improvements and an increase in the quality of life[3,4,5]
In addition, other studies published on rehabilitation after TKA12,13,38, on home versus clinic-based interventions[17] or tele-rehabilitation versus conventional rehabilitation[23,25,26]
In this study, the intervention time (10 sessions over 2 weeks) was too short to allow the detection of differences between groups, and treatment intensity was inferior to current recommendations[10,11]
Summary
TKA is associated with significant pain relief, functional improvements and an increase in the quality of life[3,4,5]. Physical rehabilitation improves results after TKA6, but the provision of these services varies widely in content and duration[7,8]. In the current context of increasing demand and a pressing need to contain expenditure[9], ensuring access to effective rehabilitation while minimizing costs is both a priority and a challenge. Home and clinic-based rehabilitation protocols have generated similar improvements[14,15,16,17,18,19]. This is in line with the recent trends in healthcare delivery, towards home-based care[20] aiming to improve cost-effectiveness
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