Wearable Sensors to Aid Rehabilitation Following Total Knee Arthroplasty: Experiences of Trial Participants.

Background Physiotherapy is key to satisfactory outcomes following total knee arthroplasty (TKA). However, financial constraints have necessitated a reduction in face-to-face post-operative outpatient physiotherapy sessions. Wearable sensors have been used for remote rehabilitation but with variable outcomes and adherence. In addition, patient experiences and views about the use of wearable sensors are rarely contextualised. Methods A single-centre prospective randomised controlled trial (RCT) is ongoing in the UK to assess the clinical and cost-effectiveness of wearable sensors in patients undergoing TKA. Participants of the accelerometry and rehabilitation after knee replacement (ARK) study were interviewed during a six-month follow-up clinic to explore trial experiences and suggestions for improvement. Responses were coded independently by two investigators using directed content analysis and a pre-determined framework of categories. Results were compared until consensus was reached. A summative approach was undertaken to analyse the resulting codes by frequency. Results Responses were recorded from 114 participants recruited in the ARK RCT: 62 from the intervention arm and 52 from the standard care arm. Common patient experience topics related to research involvement, wearable technology, rehabilitation support and communication, exercises, and general outcome. Areas for improvement included exercises, technology, questionnaires, and rehabilitation support and communication. Conclusions This study adds an important dimension to an RCT and provides direction for improvement. Research in both wearable sensors and the field of orthopaedics is often only quantitative in nature, and qualitative research provides a useful and unique dimension to these areas. Future work should further explore qualitative data in these fields.