Precision Orthopaedic Rehabilitation: Using Digital Technology for Remote Monitoring of Patient Performance and Outcomes
Stephen Edmondston1, Zaheerah Haywood1, Cade Trigg3, Mark Hurworth21St John Of God Murdoch Hospital, Murdoch, WA, Australia2Murdoch Orthopaedic Clinic, Murdoch, WA, Australia3Verve Health, West Perth, WA, Australia
Abstract
Introduction
Precision rehabilitation requires prescription of an exercise dose which is adjusted over time based on exercise performance and patient feedback. The challenge for the clinician is how to measure the exercise completed, obtain patient feedback and modify the exercise prescription accordingly. Recent developments in digital technology provide the opportunity for precisely measured, remote-monitored orthopaedic rehabilitation.
Methods
Twenty-five patients having primary knee arthroplasty were enrolled in a feasibility study to evaluate a system of remote-monitored rehabilitation. This consisted of a purpose-built portable cycle ergometer with pedal crank power meters, and digital application interface, which allows individualised exercise prescription and real-time patient feedback. Exercise was performed at a target power-output range, which is guided by real-time visual feedback. Patients provided feedback on pain and effort at the end of each exercise session. Exercise compliance (sessions completed), and patient feedback (pain and effort) are monitored and prescribed exercise adjusted remotely by the treating clinician.
Results
Patients commencing the program two weeks after surgery completed more than 90% of the prescribed exercise sessions and provided the required feedback. Improvements in lower limb muscle power output and symmetry, were observed over the four week program.. Patient experience feedback was positive in relation to system usability, communication with the clinical team and motivation to exercise.
Conclusion
Using digital technology to connect the patient and clinical team, this study demonstrates the capacity to prescribe exercise and measure patient performance in early phase rehabilitation. Remote-monitored rehabilitation may enhance access to care, and precision in exercise prescription.
Biography
Biographies to come