Effect of Lifestyle Modification Through Web-Based Telerehabilitation Monitoring Combined With Supervised Sensorimotor Training After Total Knee Arthroplasty: Randomized Controlled Trial.

IF 6.2 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Samreen Sadiq, Rabiya Noor, Rizwan Akram
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引用次数: 0

Abstract

Background: Total knee arthroplasty (TKA) is commonly performed to manage end-stage knee osteoarthritis, yet postsurgical recovery varies significantly among patients. Lifestyle modification and rehabilitation interventions play a critical role in optimizing outcomes. While telerehabilitation has shown promise in enhancing accessibility and compliance, its role in supporting lifestyle behavior change alongside supervised sensorimotor training remains underexplored.

Objective: This study aimed to evaluate the effects of a home-based lifestyle modification program delivered through web-based telerehabilitation monitoring in addition to supervised sensorimotor training, in improving physical function, pain, balance, quality of life (QOL), and adherence in patients undergoing TKA.

Methods: A single-blinded randomized controlled trial was conducted among 52 participants undergoing primary TKA, who were randomly assigned to either the intervention group (IG) (supervised sensorimotor training plus a telerehabilitation-supported lifestyle modification program) or the control group (CG) (supervised sensorimotor training alone and a traditional home exercise plan). The intervention lasted 22 weeks, and participants were assessed at baseline (presurgery), 14 weeks, and 22 weeks postsurgery. Outcome measures included joint position sense (JPS), musculoskeletal ultrasound of the rectus femoris muscle, Berg Balance Scale, knee function using the Knee Injury and Osteoarthritis Outcome Score, and QOL via EuroQol 5-dimension 5-level questionnaire.

Results: Significant improvements were observed in the IG across all outcomes compared with the CG. Notably, the IG showed greater improvements in musculoskeletal ultrasound thickness. JPS showed superior accuracy in the experimental group (baseline [3.2 degrees] to 22 wk postsurgery [0.05 degrees]) compared with the CG (baseline [3.1 degrees] to 22 wk postsurgery [1.8 degrees]), with significant improvements noted (P=.001, Cohen d=3.1 vs 0.7), Knee Injury and Osteoarthritis Outcome Score subscales (pain, symptoms, activities of daily living, sport, and QOL), and JPS (mean absolute error 0.05 vs 1.8 degrees). Berg Balance Scale demonstrated significant gains in balance for the experimental group (baseline [34] to 22 wk postsurgery [53]) relative to the CG (baseline [37] to 22 wk postsurgery [48]), with substantial differences observed (P=.001, Cohen d=1.8 vs 0.4). The EuroQol 5-dimension 5-level questionnaire health-related QOL scores were markedly higher for the experimental group (baseline [45.4] to 22 wk postsurgery [88.1]) compared with the CG (baseline [42.8] to 22 wk postsurgery [70.9]), indicating substantial gains in overall health status (P=.001, Cohen d=2.4 vs 1.3). The IG also reported higher compliance, with 81.8% (18/22) achieving over 90% adherence compared with 68.18% (15/22) in the CG.

Conclusions: Home-based lifestyle modification program through telerehabilitation monitoring significantly improved functional and patient-reported outcomes in individuals following TKA. These findings support the integration of lifestyle modification programs through telerehabilitation monitoring into post-TKA recovery pathways to optimize rehabilitation outcomes.

全膝关节置换术后通过网络远程康复监测结合监督感觉运动训练的生活方式改变的效果:随机对照试验。
背景:全膝关节置换术(TKA)是治疗终末期膝关节骨性关节炎的常用方法,但不同患者的术后恢复情况差异很大。生活方式改变和康复干预在优化结果中起着关键作用。虽然远程康复在提高可及性和依从性方面表现出了希望,但它在支持生活方式行为改变以及监督感觉运动训练方面的作用仍未得到充分探索。目的:本研究旨在评估通过基于网络的远程康复监测和监督感觉运动训练提供的基于家庭的生活方式改变计划在改善TKA患者的身体功能,疼痛,平衡,生活质量(QOL)和依从性方面的效果。方法:采用单盲随机对照试验,对52名接受原发性TKA的参与者进行了随机对照试验,他们被随机分配到干预组(IG)(有监督的感觉运动训练加远程康复支持的生活方式改变计划)和对照组(CG)(有监督的感觉运动训练和传统的家庭运动计划)。干预持续了22周,参与者在基线(手术前)、术后14周和术后22周进行评估。结果测量包括关节位置感(JPS)、股直肌肌肉骨骼超声、Berg平衡量表、膝关节损伤和骨关节炎结局评分的膝关节功能,以及EuroQol 5维5级问卷的生活质量。结果:与CG相比,IG在所有结果中均有显著改善。值得注意的是,IG显示肌肉骨骼超声厚度有更大的改善。与CG(基线[3.1度]至术后22周[1.8度])相比,实验组JPS显示出更高的准确性(基线[3.2度]至术后22周[0.05度]),有显著改善(P= 0.001, Cohen d=3.1 vs 0.7),膝关节损伤和骨关节炎结局评分亚量表(疼痛、症状、日常生活活动、运动和生活质量)和JPS(平均绝对误差0.05 vs 1.8度)。Berg平衡量表显示实验组(基线[37]至术后22周[53])相对于CG(基线[37]至术后22周[48])的平衡有显著提高,差异有统计学意义(P= 0.001, Cohen d=1.8 vs 0.4)。与CG组(基线[42.8]至术后22周[70.9])相比,实验组的EuroQol 5维5级问卷健康相关生活质量评分(基线[45.4]至术后22周[88.1])明显更高,表明整体健康状况有明显改善(P= 0.001, Cohen d=2.4 vs 1.3)。IG组也报告了更高的依从性,81.8%(18/22)的患者达到90%以上的依从性,而CG组为68.18%(15/22)。结论:通过远程康复监测的以家庭为基础的生活方式改变计划显著改善了TKA后个体的功能和患者报告的结果。这些发现支持通过远程康复监测将生活方式改变项目整合到tka后的康复途径中,以优化康复结果。
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来源期刊
JMIR mHealth and uHealth
JMIR mHealth and uHealth Medicine-Health Informatics
CiteScore
12.60
自引率
4.00%
发文量
159
审稿时长
10 weeks
期刊介绍: JMIR mHealth and uHealth (JMU, ISSN 2291-5222) is a spin-off journal of JMIR, the leading eHealth journal (Impact Factor 2016: 5.175). JMIR mHealth and uHealth is indexed in PubMed, PubMed Central, and Science Citation Index Expanded (SCIE), and in June 2017 received a stunning inaugural Impact Factor of 4.636. The journal focusses on health and biomedical applications in mobile and tablet computing, pervasive and ubiquitous computing, wearable computing and domotics. JMIR mHealth and uHealth publishes since 2013 and was the first mhealth journal in Pubmed. It publishes even faster and has a broader scope with including papers which are more technical or more formative/developmental than what would be published in the Journal of Medical Internet Research.
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