Trial reportJournal of medical Internet research2025
Effectiveness of the Self-Directed mHealth Exercise Intervention re.flex in Patients With Knee Osteoarthritis: Randomized Controlled Trial.
Trial report in Journal of medical Internet research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Effects of Digital Health Interventions in Chronic Musculoskeletal Pain: Systematic Review and Bayesian Network Meta-Analysis of Randomized Controlled Trials.Journal of medical Internet research · 2026Pooled it
- Process evaluation of an integrated personalized eHealth programme after total and unicompartmental knee arthroplasty-Results of the multicenter ACTIVE randomized controlled trial.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Trial
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: About 1 in 2 patients with knee osteoarthritis (OA) receives a referral or recommendation for exercise. Digital health applications could counteract this undersupply. Objective: We aimed to investigate the effectiveness of a 12-week self-directed mobile health exercise intervention (re.flex) when used in addition to usual care compared to a control group receiving usual care only on pain reduction and improvement in physical function in patients with knee OA. Methods: This monocentric, 2-arm, randomized controlled parallel-group trial included patients from Germany with moderate to severe knee OA. Participants were mainly recruited via newspapers. Randomization was 1:1 into an intervention group (re.flex+usual care) and a control group (usual care) using computer-generated blocks. Participants were unmasked to group assignment. The re.flex group conducted a 12-week self-directed app-based and sensor-assisted exercise program with 3 sessions per week in addition to usual care. Primary outcomes were OA-specific knee pain and physical function (using the subscales pain and activities in daily living of the Knee Osteoarthritis Outcome Score, 0-100) at 3 months. Secondary outcomes included adherence and safety. Multiple imputation was used to account for missing data. Intervention effects were calculated using a baseline-adjusted analyses of covariance (ANCOVA). Bonferroni correction with an alpha level of .025 was applied. Results: Between January 25, 2023, and August 11, 2023, a total of 195 participants were enrolled. Of them, 98 participants were allocated to re.flex, and 97 participants to usual care. The primary analysis included 194 participants. The mean age was 61.9 (SD 7.7) years, and the majority were female (132/194, 68%). Pain reduction was significantly larger in re.flex than in usual care, with an adjusted mean difference between study groups of 4.8 (95% CI 0.7-8.9; P=.02; Cohen d=0.35) points. Improvement in physical function was not statistically significant (beta coefficient [β]=3.9 points, 95% CI 0.0-7.9, P=.049). A total of 12 adverse events were linked to re.flex, none of which were serious. Participants adhered to 77% (2705/3528) of all scheduled exercise sessions. Conclusions: The self-directed sensor-based mobile health exercise intervention re.flex demonstrates superiority over usual care for pain reduction and justifies this kind of intervention as an alternative exercise delivery mode for patients with knee OA.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.