Evidence map›Paper›PMID 39511552›Full record

ArticleBMC musculoskeletal disorders2024

Design and development of a mobile health intervention for rehabilitation support after knee arthroplasty: TeleRehabilitation after knee ArThroplasty (TReAT) project.

Sabhya Pritwani, Siaa Girotra, Purnima Shrivastava, Ajit Kumar, Arun M Swamy, Sahil Batra, Neetu Sharma, Renu John, Devarsetty Praveen, Sridevi Gara and 3 more

Abstract read
In one paragraph

Article in BMC musculoskeletal disorders, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Sabhya Pritwani *The George Institute for Global Health India, Delhi, India.
Siaa Girotra *The George Institute for Global Health India, Delhi, India.
Purnima ShrivastavaThe George Institute for Global Health India, Delhi, India.
Ajit KumarDepartment of Orthopaedics, All India Institute of Medical Sciences, Delhi, India.
Arun M SwamyDepartment of Orthopaedics, All India Institute of Medical Sciences, Delhi, India.
Sahil BatraDepartment of Orthopaedics, All India Institute of Medical Sciences, Delhi, India.
Neetu SharmaDepartment of Orthopaedics, All India Institute of Medical Sciences, Delhi, India.
Renu JohnThe George Institute for Global Health India, Delhi, India.
Devarsetty PraveenThe George Institute for Global Health India, Delhi, India.
Sridevi GaraThe George Institute for Global Health India, Delhi, India.
Rajesh MalhotraDepartment of Orthopaedics, All India Institute of Medical Sciences, Delhi, India.
Ralph MaddisonInstitute for Physical Activity and Nutrition, Department of School of Exercise & Nutrition, Deakin University, Geelong, VIC, Australia.
Niveditha DevasenapathyThe George Institute for Global Health India, Delhi, India. ndevasenapathy@georgeinstitute.org.in.

Funding

Wellcome Trust DBT India Alliance IA/CPHI/20/1/505224
6 · The paper itself

Abstract

backgroundThe steep increase in knee arthroplasties in lower- and middle-income countries has increased demand for personalised rehabilitation care. Technology-based rehabilitation programs offer potential to replace or augment conventional face-to-face rehabilitation for providing continuum of care. We aimed to systematically develop a theory, evidence-driven, contextualised, and user-centred mobile health platform for people undergoing knee arthroplasty to facilitate monitoring progress during rehabilitation.

methodsWe followed the UK Medical Research Council's framework and adopted a behaviour design thinking approach, consisting of five steps; (1) conduct multiple literature reviews and cross-sectional surveys to determine the needs and problems experienced during the rehabilitation phase by healthcare professionals and individuals with replaced knees, (2) identify target behaviours along with barriers and facilitators, integrated within the Capability, Opportunity, Motivation-Behaviour (COM-B) framework, (3) identify intervention functions and components, behaviour change techniques, and features for the mobile application, selected after discussions with orthopaedic surgeons, physiotherapists and behavioural experts, (4) develop a prototype application for end-users, and a web-based platform for healthcare professionals, and (5) pilot test the intervention for end-users' feedback on usability of the application and to identify possible strategies for implementing the intervention package.

resultsUsing the COM-B model, education, training, persuasion, enablement, and modelling were chosen as intervention functions for improving adherence to exercise protocol during early-phase of rehabilitation. The application featured five interlinked components; education, training, goal setting and self-management, communication, and a personalized therapy plan utilising 13 behaviour change techniques. An education booklet, exercise videos, text messaging, video consultation, and a digital tool for measuring range of motion were incorporated into the application. Feedback on the interactive prototype and education material was sought from ten patient volunteers and a physiotherapist. Pilot testing in a convenient sample with broad eligibility criteria (n = 30) indicated importance of digital literacy and dedicated time for remote consultation by healthcare provider within the existing clinical work. Overall, the intervention was well received and valued by the end users.

conclusionThis paper demonstrates the development of a contextualised digital behavioural intervention grounded in behavioural theory and evidence from literature to improve end-user's engagement with rehabilitation protocols after knee arthroplasty in lower- and middle-income country context.

trial registrationStudy registered prospectively (on 16 February 2023) at Clinical Trials Registry of India (CTRI/2023/02/049792).

Indexed as

Arthroplasty, Replacement, KneeMobile ApplicationsTelerehabilitationCross-Sectional StudiesFemaleHumansMaleMiddle AgedPilot ProjectsTelemedicineTreatment OutcomeKnee arthroplastyMobile applicationTelemedicineTelemonitoringTelerehabilitation

Identifiers

PMID39511552
PMCPMC11542399

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.