Eleanor Chew1,2, Aileen Eugenia Scully3, Samantha Shi-Man Koh1, Ee-Lin Woon1, Juanita Krysten Miao-Shi Low1, Yu-Heng Kwan4, John Wei-Ming Tan1, Yong-Hao Pua2,5, Celia la-Choo Tan2, Luke Jonathan Haseler2
1Department of Physiotherapy, Singapore General Hospital, Singapore, 2Curtin School of Allied Health, Curtin University, Perth, Australia, 3Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore, 4Programme in Health Services and System Research, Duke-NUS Medical School, Singapore, 5Medicine Academic Programme, Duke-NUS Graduate Medical School, Singapore
Biography:
Eleanor Chew is a physiotherapist with 18 years of experience at Singapore General Hospital and a PhD candidate at Curtin University, Perth, Australia. She holds a Master’s degree in Clinical Management of Pain from Edinburgh University and has received notable accolades, including the SingHealth Outstanding Allied Health Professional Award (2018, Singapore) and the National Day Commendation Medal (2024, Singapore).
She is the Lead of the Rehabilitation and Therapeutic Service Section in the Allied Health Division at Singapore General Hospital and a strong advocate for Value-Based Health Care. Internationally, she has contributed to training physiotherapists in Papua New Guinea and Cambodia, while her research focuses on joint replacement rehabilitation and health service improvements. She recently won Best Oral Presentation at the 2024 International Allied Health Conference.
Abstract:
Background:
Total knee arthroplasty (TKA) is a cost-effective surgical intervention for painful knee osteoarthritis in older adults, but access to post-surgery rehabilitation remains limited. While tele-rehabilitation provides a potential solution, existing models require significant therapist involvement and costly setups. A personalised, smartphone-based automated program could serve as a more cost-effective alternative.
Objective:
This study aimed to understand the requirements of both patients and physiotherapists in developing an automated tele-monitored rehabilitation smartphone application for individuals undergoing TKA. To ensure uptake and long-term sustainability, a person-based approach was adopted.
Methods:
A multi-stakeholder qualitative study was conducted to assess user needs. Physiotherapists and patients who had undergone TKA were recruited via purposive sampling. Individual, hour-long in-depth interviews were conducted via Zoom by an experienced, trained female interviewer with a Master of Arts in Sociology. Interviews were audio-recorded and transcribed by the same interviewer. Two reviewers (ESC, SSK) independently analysed the data using thematic analysis, with data triangulation achieved through cross-checking among three reviewers (ESC, SSK, AES). Interviews continued until data saturation was reached.
Results:
Six patients and four physiotherapists participated.
For the patient interface, participants emphasised ease of use and identified key features such as a search function and multilingual options.
For the physiotherapist interface, ease of accessing patient data and outcome measures was considered critical for effective monitoring.
Both groups highlighted the importance of:
– Timely, condition-specific information supplemented by visual aids for exercise guidance, pain management, and recovery goals
– Progress tracking, feedback, and access to healthcare professionals for reassurance
– Motivational features, including reminders, prompts, and exercise logs to improve adherence
– Initial training support to ensure confident use of the application
Conclusion:
This study provided key insights into the requirements of potential end-users for a smartphone application designed for automated tele-monitored rehabilitation following TKA. These findings will help guide the development of a user-centric application that meets both patient and physiotherapist needs.