{"title":"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","authors":"Arpitha Pamula, Katie Lee, Alex Tang, Tan Chen","doi":"10.1097/BSD.0000000000001903","DOIUrl":null,"url":null,"abstract":"<p><strong>Study design: </strong>Retrospective study.</p><p><strong>Objective: </strong>(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.</p><p><strong>Summary of background data: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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%).</p><p><strong>Conclusions: </strong>Mobile applications for postoperative rehabilitation demonstrated low clinical utility following ACDF or PDIF for degenerative diseases, despite high patient compliance and growing popularity.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7000,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Clinical Utility and Patient Compliance With Mobile Applications for Home-based Rehabilitation Following Cervical Spine Fusion.\",\"authors\":\"Arpitha Pamula, Katie Lee, Alex Tang, Tan Chen\",\"doi\":\"10.1097/BSD.0000000000001903\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Study design: </strong>Retrospective study.</p><p><strong>Objective: </strong>(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.</p><p><strong>Summary of background data: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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%).</p><p><strong>Conclusions: </strong>Mobile applications for postoperative rehabilitation demonstrated low clinical utility following ACDF or PDIF for degenerative diseases, despite high patient compliance and growing popularity.</p><p><strong>Level of evidence: </strong>Level III.</p>\",\"PeriodicalId\":10457,\"journal\":{\"name\":\"Clinical Spine Surgery\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-08-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Spine Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/BSD.0000000000001903\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Spine Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/BSD.0000000000001903","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Clinical Utility and Patient Compliance With Mobile Applications for Home-based Rehabilitation Following Cervical Spine Fusion.
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.
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.
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