Evidence map›Paper›PMID 41298260›Full record

ArticleBMJ open2025

How effective is mHealth-supported home-based post-knee arthroplasty rehabilitation in improving knee function and continuum of care: protocol of an open label randomised controlled trial from India.

Siaa Girotra, Purnima Shrivastava, Ajit Kumar, Ruchika Madan, Seema Grover, Sahil Batra, Bhavuk Garg, Devarsetty Praveen, Susmita Chatterjee, Ankita Kasotia and 6 more

Abstract readClinical Trial Protocol
In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Article
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

16 authors.

Siaa GirotraThe George Institute for Global Health, New Delhi, India.
Purnima ShrivastavaThe George Institute for Global Health, New Delhi, India.
Ajit KumarDepartment of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.
Ruchika MadanDepartment of Geriatric Medicine, All India Institute of Medical Sciences, New Delhi, India.
Seema GroverDepartment of Physiotherapy and Rehabilitation, Indraprastha Apollo Hospitals, New Delhi, India.
Sahil BatraDepartment of Geriatric Medicine, All India Institute of Medical Sciences, New Delhi, India.
Bhavuk GargDepartment of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.
Devarsetty PraveenThe George Institute for Global Health India, New Delhi, India.
Susmita ChatterjeeThe George Institute for Global Health, New Delhi, India.ORCID http://orcid.org/0000-0002-0937-7205
Ankita KasotiaThe George Institute for Global Health, New Delhi, India.
Shyamashree BiswasThe George Institute for Global Health, New Delhi, India.
Manoj SoniThe George Institute for Global Health, New Delhi, India.
Sridevi GaraThe George Institute for Global Health, New Delhi, India.
Rajesh MalhotraDepartment of Orthopedics, Indraprastha Apollo Hospitals, New Delhi, India.
Ralph MaddisonDeakin University Institute for Physical Activity and Nutrition, Geelong, Victoria, Australia.
Niveditha DevasenapathyThe George Institute for Global Health, New Delhi, India ndevasenapathy@georgeinstitute.org.in.

Funding

Wellcome Trust
6 · The paper itself

Abstract

introductionMonitoring physical rehabilitation is an essential component of patient recovery after knee arthroplasty. Monitoring can be remote, or clinic based. In India, unsupervised home-based physical rehabilitation is a common practice, but there is a lack of evidence to demonstrate the effectiveness of remote monitoring. Therefore, we developed and piloted a mobile application (TeleREhabilitation after knee ArThroplasty app) based on behaviour design thinking to support the recovery period. This trial aims to compare the effectiveness, acceptability, cost and safety of this app-supported home-based intervention against usual care using an open label, 1:1 individual randomised superiority trial at two tertiary care hospitals in India. METHODS AND ANALYSIS: Consecutive adults undergoing partial or total, unilateral or bilateral knee arthroplasty who can use a smart phone will be invited to participate in this trial. Consenting individuals will be randomised to either an app-supported intervention or a usual home-based rehabilitation which typically consists of provision of oral or written instructions at discharge and follow-up check-up with the surgeon or physiotherapist at their discretion or as per individual need. We aim to recruit 300 individuals over a period of eighteen months. The primary objective is to compare patient-reported knee function between the two groups at 3 and 6 months postsurgery. Secondary objectives are to compare patient-reported outcomes (pain and activity), performance-based outcomes (lower limb strength and knee function), resource utilisation and quality of life. Fidelity of implementation, end-user experiences and challenges in implementing this intervention will be measured using both quantitative and qualitative methods. Quantitative data will be analysed in Stata, and group comparisons will be done using mixed effect linear regression. A mixed-methods approach will be used to analyse and interpret the process evaluation data. A modified intention-to-treat approach will be taken, which includes all those who were randomised irrespective of their adherence to trial protocol if they had at least one follow-up visit after enrolment. ETHICS AND DISSEMINATION: The protocol has been approved by the ethics committees of the sponsor institute (The George Institute for Global Health) and the two clinical sites (All India Institute for Medical Sciences, Delhi & Indraprastha Apollo Hospitals, Delhi). The results will be disseminated via peer-reviewed publications, conference presentations and via plain language newsletters to the trial participants. TRIAL REGISTRATION NUMBER: CTRI/2024/06/068838.

Indexed as

Arthroplasty, Replacement, KneeContinuity of Patient CareMobile ApplicationsEquivalence Trials as TopicFemaleHumansIndiaMaleRandomized Controlled Trials as TopicRecovery of FunctionTelemedicineTelerehabilitationClinical TrialKneeMobile ApplicationsREHABILITATION MEDICINETelemedicine

Identifiers

PMID41298260
PMCPMC12658543

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.