Clinical Utility and Patient Compliance With Mobile Applications for Home-based Rehabilitation Following Cervical Spine Fusion.

IF 1.7 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Spine Surgery Pub Date : 2025-08-22 DOI:10.1097/BSD.0000000000001903

Arpitha Pamula, Katie Lee, Alex Tang, Tan Chen

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引用次数: 0

Abstract

Study design: Retrospective study.

Objective: (1) To compare patient-reported outcome measures (PROMs) between postoperative patients who were the most and least compliant in using mobile-based rehabilitation programs, (2) compare PROMs between patients undergoing anterior cervical discectomy and fusion (ACDF) versus cervical posterior decompression and instrumented fusion (PDIF), and (3) quantify the overall compliance rate.

Summary of background data: Mobile applications for rehabilitation have been widely used following orthopedic procedures. There is limited data describing the utility and compliance with self-directed programs and their effects on PROMs following ACDF or PDIF.

Methods: A retrospective review was performed identifying patients who underwent elective ACDF or cervical PDIF for degenerative pathology. Patient-Reported Outcomes Measurement Information System (PROMIS) and Neck Disability Index (NDI) scores were collected perioperatively and assessed longitudinally. Patients were separated into 2 study groups based on application compliance and fusion construct. Patient compliance and engagement were defined as those who downloaded the application (DL+) and set therapy session reminders (R+) on their mobile devices. Compliance rate was calculated as the difference between the number of active participants at the preoperative phase and final follow-up. Descriptive and inferential statistics were performed.

Results: A total of 775 patients (ACDF, n=571; PDIF, n=204) were included. No difference was found in ∆PROMIS overall (P=0.205) or ∆NDI (P=0.441) regardless of patient compliance and engagement to the therapy program. No difference was found in the improvement of outcomes scores between ACDF or PDIF cohorts as stratified by DL+/DL- and R+/R- at any postoperative point. Overall patient compliance rate to the program at final postoperative follow-up was 71% (ACDF: 71.8%, PDIF: 69.2%).

Conclusions: Mobile applications for postoperative rehabilitation demonstrated low clinical utility following ACDF or PDIF for degenerative diseases, despite high patient compliance and growing popularity.

Level of evidence: Level III.

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颈椎融合术后家庭康复中移动应用的临床应用和患者依从性

研究设计：回顾性研究。目的：(1)比较患者报告的预后指标（PROMs）在最顺应和最不顺应使用移动康复方案的术后患者之间，(2)比较前路颈椎椎间盘切除术和融合（ACDF）与颈椎后路减压和内固定融合（PDIF）患者之间的PROMs，(3)量化总体顺应率。背景资料摘要：骨科手术后，康复的移动应用程序已被广泛使用。描述自我指导程序的效用和依从性及其对ACDF或PDIF后prom的影响的数据有限。方法：对因退行性病理行选择性ACDF或颈椎PDIF的患者进行回顾性分析。围手术期收集患者报告的预后测量信息系统（PROMIS）和颈部残疾指数（NDI）评分，并进行纵向评估。根据应用依从性和融合结构将患者分为2个研究组。患者依从性和参与度定义为下载应用程序（DL+）并在移动设备上设置治疗会话提醒（R+）的患者。依从率计算为术前积极参与者人数与最后随访人数之差。进行描述性和推断性统计。结果：共纳入775例（ACDF, n=571； PDIF, n=204）。无论患者依从性和对治疗方案的参与程度如何，总体上的∆PROMIS （P=0.205）或∆NDI （P=0.441）均无差异。以DL+/DL-和R+/R-分级，ACDF组和PDIF组在术后任何时间点的预后评分改善均无差异。术后最终随访时患者对该方案的总体依从率为71% （ACDF: 71.8%, PDIF: 69.2%）。结论：尽管ACDF或PDIF治疗退行性疾病的患者依从性高且越来越受欢迎，但术后康复的移动应用程序的临床实用性较低。证据等级：三级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Spine Surgery Medicine-Surgery

CiteScore

3.00

自引率

5.30%

发文量

236

期刊介绍： Clinical Spine Surgery is the ideal journal for the busy practicing spine surgeon or trainee, as it is the only journal necessary to keep up to date with new clinical research and surgical techniques. Readers get to watch leaders in the field debate controversial topics in a new controversies section, and gain access to evidence-based reviews of important pathologies in the systematic reviews section. The journal features a surgical technique complete with a video, and a tips and tricks section that allows surgeons to review the important steps prior to a complex procedure. Clinical Spine Surgery provides readers with primary research studies, specifically level 1, 2 and 3 studies, ensuring that articles that may actually change a surgeon’s practice will be read and published. Each issue includes a brief article that will help a surgeon better understand the business of healthcare, as well as an article that will help a surgeon understand how to interpret increasingly complex research methodology. Clinical Spine Surgery is your single source for up-to-date, evidence-based recommendations for spine care.