ActiveHip+: A feasible mHealth system for the recovery of older adults after hip surgery during the COVID-19 pandemic

Abstract

Objective Half of older adults undergoing hip surgery do not recover their previous functional status. mHealth is a promising tool for rehabilitating older adults after hip surgery. This study aimed to test the feasibility of the ActiveHip+ mHealth system in older adults after hip surgery. Methods Sixty-nine older adults who had undergone hip surgery and their family caregivers were recruited from hospitals in Spain and Belgium and used the ActiveHip+ mHealth system for 12 weeks. Assessments were made during hospital stay and 3 months after surgery. Feasibility assessment included: adoption (participation proportion), usage (access to the app), satisfaction with the app (Net Promoter Score) and user perception of the quality of the app (Mobile App Rating Scale). Clinical assessment included: patient-reported outcomes, such as functional status (Functional Independence Measure) and performance-based outcomes, such as physical fitness (Short Physical Performance Battery). Results The ActiveHip+ mHealth system obtained satisfactory feasibility results in both countries. In Spain, we observed 85% adoption, 64% usage, 8.86/10 in satisfaction with the app and 4.42/5 in perceived quality of the app. In Belgium, we observed 82% adoption, 84% usage, 5.16/10 in satisfaction with the app and 3.52/5 in app's perceived quality. The intervention had positive effects on levels of functional status, pain and physical fitness. Conclusions The ActiveHip+ mHealth system is a feasible tool to conduct the rehabilitation in older adults after hip surgery. Although the intervention seemed beneficial clinically, we do not recommend its implementation in clinical settings until appropriately designed randomised clinical trials confirm these results.

A systematic review of digital health technologies for the care of older adults during COVID-19 pandemic

“… 50 Other chronic diseases or symptoms included pain, 51 type 2 diabetes, 42 , 52 Parkinsonism, 53 rheumatoid arthritis, 54 and obesity. 42 , 55 It is worth mentioning that two studies targeted both older adults and caregivers, 49 , 56 and one study also included grandparents and grandchildren. 57 …”

“…DHTs encompassed various distinct applications, such as health care services delivered via television, 47 telephone, 51 , 58 , 59 video meeting, 46 , 48 , 49 , 60 social media, 45 , 61 mobile applications, 53 , 56 and website-based telehealth. 50 , 52 , 55 In addition to “traditional” DHTs, several new approaches were implemented in health care sectors.…”

“… 50 Despite the promising feasibility of DHTs for older adults, Prieto-Moreno et al emphasized the limitations in preliminary results and called for future RCTs to better measure the clinical outcomes of DHTs. 56 …”

Telerehabilitation After Hip-Fracture Surgery

“…They concluded that although the Telerehabilitation group had better outcomes in terms of fall efficacy and instrumental ADL performance, the lack of social support in the control group may contribute to this difference [18]. One of the biggest studies about telerehabilitation on hip fracture was by Prieto-Moreno et al [19]. This study included patients from Spain and Belgium, using the Active hip+ mHealth for 12 weeks, and showed high rates of adaptation and usage of active hip+ after hip fracture [19].…”

“…One of the biggest studies about telerehabilitation on hip fracture was by Prieto-Moreno et al [19]. This study included patients from Spain and Belgium, using the Active hip+ mHealth for 12 weeks, and showed high rates of adaptation and usage of active hip+ after hip fracture [19]. The study compared the functional recovery of older adults with hip fractures between a multidisciplinary telerehabilitation program and home-based in-person rehabilitation by Ortiz-Piña et al [20].…”