Background The use of mobile health (mHealth) apps is becoming increasingly widespread. However, little is known about the attitudes, expectations, and basic acceptance of health care professionals toward such treatment options. As physical activity and behavior modification are crucial in osteoarthritis management, app-based therapy could be particularly useful for the self-management of this condition. Objective The objective of the study was to determine the expectations and attitudes of medical professionals toward app-based therapy for osteoarthritis of the hip or knee. Methods Health care professionals attending a rehabilitation congress and employees of a university hospital were asked to fill out a questionnaire consisting of 16 items. A total of 240 questionnaires were distributed. Results A total of 127 participants completed the questionnaire. At 95.3% (121/127), the approval rate for app-based therapy for patients with osteoarthritis of the hip or knee was very high. Regarding possible concerns, aspects related to data protection and privacy were primarily mentioned (41/127, 32.3%). Regarding potential content, educational units, physiotherapeutic exercise modules, and practices based on motivation psychology were all met with broad approval. Conclusions The study showed a high acceptance of app-based therapy for osteoarthritis, indicating a huge potential of this form of treatment to be applied, prescribed, and recommended by medical professionals. It was widely accepted that the content should reflect a multimodal therapy approach.

Background The use of digital therapeutic solutions for rehabilitation of conditions such as osteoarthritis provides scalable access to rehabilitation. Few validated technological solutions exist to ensure supervision of users while they exercise at home. Motion Coach (Kaia Health GmbH) provides audiovisual feedback on exercise execution in real time on conventional smartphones. Objective We hypothesized that the interrater agreement between physiotherapists and Motion Coach would be noninferior to physiotherapists’ interrater agreement for exercise evaluations in a cohort with osteoarthritis. Methods Patients diagnosed with osteoarthritis of the knee or hip were recruited at a university hospital to perform a set of 6 exercises. Agreement between Motion Coach and 2 physiotherapists’ corrections for segments of the exercises were compared using Cohen κ and percent agreement. Results Participants (n=24) were enrolled and evaluated. There were no significant differences between interrater agreements (Motion Coach app vs physiotherapists: percent agreement 0.828; physiotherapist 1 vs physiotherapist 2: percent agreement 0.833; P<.001). Age (70 years or under, older than 70 years), gender (male, female), or BMI (30 kg/m2 or under, greater than 30 kg/m2) subgroup analysis revealed no detectable difference in interrater agreement. There was no detectable difference in levels of interrater agreement between Motion Coach vs physiotherapists and between physiotherapists in any of the 6 exercises. Conclusions The results demonstrated that Motion Coach is noninferior to physiotherapist evaluations. Interrater agreement did not differ between 2 physiotherapists or between physiotherapists and the Motion Coach app. This finding was valid for all investigated exercises and subgroups. These results confirm the ability of Motion Coach to detect user form during exercise and provide valid feedback to users with musculoskeletal disorders.

Background Early mobilization positively influences the outcome of critically ill patients, yet in clinical practice, the implementation is sometimes challenging. In this study, an adaptive robotic assistance system will be used for early mobilization in intensive care units. The study aims to evaluate the experience of the mobilizing professionals and the general feasibility of implementing robotic assistance for mobilization in intensive care as well as the effects on patient outcomes as a secondary outcome. Methods The study is single-centric, prospective, and interventional and follows a longitudinal study design. To evaluate the feasibility of robotic-assisted early mobilization, the number of patients included, the number of performed VEM (very early mobilization) sessions, and the number and type of adverse events will be collected. The behavior and experience of mobilizing professionals will be evaluated using standardized observations (n > 90) and episodic interviews (n > 36) before implementation, shortly after, and in routine. Patient outcomes such as duration of mechanical ventilation, loss of muscle mass, and physical activity will be measured and compared with a historical patient population. Approximately 30 patients will be included. Discussion The study will provide information about patient outcomes, feasibility, and the experience of mobilizing professionals. It will show whether robotic systems can increase the early mobilization frequency of critically ill patients. Within ICU structures, early mobilization as therapy could become more of a focus. Effects on the mobilizing professionals such as increased motivation, physical relief, or stress will be evaluated. In addition, this study will focus on whether current structures allow following the recommendation of mobilizing patients twice a day for at least 20 min. Trial registration ClinicalTrials.gov, NCT05071248. Date: 2021/10/21

Background Early mobilization can help reduce severe side effects such as muscle atrophy that occur during hospitalization. However, due to time and staff shortages in intensive and critical care as well as safety risks for patients, it is often difficult to adhere to the recommended therapy time of twenty minutes twice a day. New robotic technologies might be one approach to achieve early mobilization effectively for patients and also relieve users from physical effort. Nevertheless, currently there is a lack of knowledge regarding the factors that are important for integrating of these technologies into complex treatment settings like intensive care units or rehabilitation units. Methods European experts from science, technical development and end-users of robotic systems (n = 13) were interviewed using a semi-structured interview guideline to identify barriers and facilitating factors for the integration of robotic systems into daily clinical practice. They were asked about structural, personnel and environmental factors that had an impact on integration and how they had solved challenges. A latent content analysis was performed regarding the COREQ criteria. Results We found relevant factors regarding the development, introduction, and routine of the robotic system. In this context, costs, process adjustments, a lack of exemptions, and a lack of support from the manufacturers/developers were identified as challenges. Easy handling, joint decision making between the end-users and the decision makers in the hospital, an accurate process design and the joint development of the robotic system of end-users and technical experts were found to be facilitating factors. Conclusion The integration and preparation for the integration of robotic assistance systems into the inpatient setting is a complex intervention that involves many parties. This study provides evidence for hospitals or manufacturers to simplify the planning of integrations for permanent use. Trial registration DRKS-ID: DRKS00023848; registered 10/12/2020.

QR-Code scannen & Beitrag online lesen Zusammenfassung Hintergrund: Bei etwa 43 % aller Überlebenden der Intensivmedizin wird ein erworbenes Syndrom an Muskelschwäche beobachtet, welches Überleben und Lebensqualität vermindert. Da kausale Therapieoptionen bisher fehlen, stehen die Vermeidung der bekannten Risikofaktoren und Frühmobilisation im Vordergrund. Robotische Unterstützungssysteme werden vermehrt in der Mobilisation erprobt. Ziel der Arbeit: In diesem Übersichtsartikel wird die aktuelle Evidenz von Frühmobilisation von kritisch Kranken zusammengefasst und der Stellenwert robotischer Assistenzsysteme für Mobilisation diskutiert. Ergebnisse: Mobilisation sollte auf der Intensivstation nach Möglichkeit früh begonnen werden. Hierunter wird der Beginn in den ersten 72 h nach der Aufnahme auf die Intensivstation verstanden. Physiotherapeutische Interventionen während des Intensivaufenthalts zeigen positive Effekte auf die Lebensqualität von PatientInnen, auf die Dauer von invasiver Beatmung, Intensivaufenthalt und Delir. Strukturierte Behandlungsprotokolle führen zu mehr aktiver Mobilisation, höherer Mobilität und häufigerer funktioneller Unabhängigkeit bei Entlassung aus dem Krankenhaus. Nach Schlaganfällen erhöhen zusätzliche robotergestützte Therapieeinheiten insbesondere bei stärker eingeschränkten PatientInnen die Rate an Rückkehrern zum selbstständigen Gehen, scheinen sicher und verbesserten in kleinen Studien Muskelkraft und Lebensqualität. Schlussfolgerung: Frühmobilisation verbessert das Outcome von kritisch Erkrankten. Robotische Systeme unterstützen das Gangtraining nach einem Schlaganfall und werden auf der Intensivstation in ersten Studien zu Vertikalisierung und Frühmobilisation untersucht.