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Scrivener K1, Llado A2, Bui T2
1Macquarie University, Health Professions, Sydney, Australia, 2Royal Rehabilitation Private Hospital, Sydney, Australia
Background: There is a known positive relationship between time in therapy and rehabilitation outcomes, with larger doses of therapy leading to clinically meaningful improvements. However, in practice rehabilitation inpatients do not always receive optimal amounts of physical therapy. One strategy to increase activity levels in rehabilitation is to increase the amount of exercise individuals can undertake in their own time, outside of scheduled therapy sessions. Some therapists prescribe supplemental exercise programs (programs that are completed independently, outside scheduled therapy sessions) to individuals in rehabilitation and/or their carers either verbally or on paper. New, affordable technologies such as the iPad, have the potential to deliver supplemental exercise programs in a more engaging way.
Purpose: To investigate whether an app-based supplemental exercise program in inpatient orthopaedic rehabilitation will be feasible and acceptable to participants, increase activity levels and improve functional outcomes.
Methods: A single-centre, single-blind, pilot randomised control trial was conducted. The trial was set in an inpatient private general rehabilitation unit. Participants included twenty individuals admitted for orthopaedic rehabilitation over four-week duration. Participants were randomised to receive supplemental exercise via an application (PTPalTM) on a tablet device additional to usual care (intervention group) or usual care alone (control group). Primary outcome measures were; participant satisfaction with app-based supplemental exercise, total repetitions of each activity and time in supplemental exercise programs. Secondary measures were; 10 Metre Walk Test; 6 Minute Walk Test; Timed Up and Go; Functional Independence Measure and length of stay assessed by a blinded assessor.
Results: This novel research demonstrates high acceptance of the app-based supplemental exercise program. Those using the app completed an additional 549 exercise repetitions during their admission (694 supplemental repetitions in intervention vs 146 repetitions in control group, Mean Difference [MD] 549, 95% CI 95 to 1002, p=0.02) and an additional 157 minutes participating in supplemental exercise throughout their admission (195.3min in intervention vs 38.7min in control, MD 157mins, 95% CI 0.9-312.3min, p=0.05). There was insufficient power to demonstrate statistical significance in functional outcomes.
Conclusion(s): An app-based exercise program increases activity levels, is feasible and is a safe intervention within inpatient orthopaedic rehabilitation, with the potential to improve functional outcomes.
Implications: It is feasible to use supplemental app-based exercise within inpatient orthopaedic rehabilitation. This pilot study should be followed with a larger study to determine effectiveness of an app-based supplemental exercise program in rehabilitation.
Keywords: Orthopaedic, Rehabilitation, Technology
Funding acknowledgements: Royal Rehab Foundation paid the annual subscription payment of $1120 AUD to PTPalTM
Purpose: To investigate whether an app-based supplemental exercise program in inpatient orthopaedic rehabilitation will be feasible and acceptable to participants, increase activity levels and improve functional outcomes.
Methods: A single-centre, single-blind, pilot randomised control trial was conducted. The trial was set in an inpatient private general rehabilitation unit. Participants included twenty individuals admitted for orthopaedic rehabilitation over four-week duration. Participants were randomised to receive supplemental exercise via an application (PTPalTM) on a tablet device additional to usual care (intervention group) or usual care alone (control group). Primary outcome measures were; participant satisfaction with app-based supplemental exercise, total repetitions of each activity and time in supplemental exercise programs. Secondary measures were; 10 Metre Walk Test; 6 Minute Walk Test; Timed Up and Go; Functional Independence Measure and length of stay assessed by a blinded assessor.
Results: This novel research demonstrates high acceptance of the app-based supplemental exercise program. Those using the app completed an additional 549 exercise repetitions during their admission (694 supplemental repetitions in intervention vs 146 repetitions in control group, Mean Difference [MD] 549, 95% CI 95 to 1002, p=0.02) and an additional 157 minutes participating in supplemental exercise throughout their admission (195.3min in intervention vs 38.7min in control, MD 157mins, 95% CI 0.9-312.3min, p=0.05). There was insufficient power to demonstrate statistical significance in functional outcomes.
Conclusion(s): An app-based exercise program increases activity levels, is feasible and is a safe intervention within inpatient orthopaedic rehabilitation, with the potential to improve functional outcomes.
Implications: It is feasible to use supplemental app-based exercise within inpatient orthopaedic rehabilitation. This pilot study should be followed with a larger study to determine effectiveness of an app-based supplemental exercise program in rehabilitation.
Keywords: Orthopaedic, Rehabilitation, Technology
Funding acknowledgements: Royal Rehab Foundation paid the annual subscription payment of $1120 AUD to PTPalTM
Topic: Orthopaedics; Disability & rehabilitation; Musculoskeletal
Ethics approval required: Yes
Institution: The Northern Sydney Local Health District
Ethics committee: Human Research Ethics Committee
Ethics number: HREC/14/HAWKE/444
All authors, affiliations and abstracts have been published as submitted.
