Using Mobile Tracking Technology to Visualize the Trajectory of Recovery after Hip Arthroscopy: A Case Report

Mehta, Nabil; Steiner, Claire; Fields, Kara G.; Nawabi, Danyal H.; Lyman, Stephen

doi:10.1007/s11420-017-9544-x

Cited by 12 publications

(8 citation statements)

References 24 publications

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“…The Moves™ app (no longer available as of June 2018), which used a phone's accelerometer to count daily steps, was installed on patients’ smartphones to gather data pre-operatively and for at least 6 months of their post-operative recovery [23]. During this period, patients also completed PROMs via a mobile-enabled web link including the pain numeric rating scale (NRS), the HOOS or KOOS quality of life (QOL) domain, and the HOOS or KOOS JR. PROMs were administered weekly, 2 weeks prior and up to 12 weeks after surgery and then once every 2 weeks up to 6 months after surgery.…”

Section: Methodsmentioning

confidence: 99%

Monitoring Patient Recovery after THA or TKA using Mobile Technology

Lyman

Hidaka

Fields

et al. 2020

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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Background Smartphones offer the possibility of assessing recovery of mobility after total hip or knee arthroplasty (THA or TKA) passively and reliably, as well as facilitating the collection of patient-reported outcome measures (PROMs) with greater frequency. Questions/Purposes We investigated the feasibility of using mobile technology to collect daily step data and biweekly PROMs to track recovery after total joint arthroplasty. Methods Pre- and post-operative daily steps were recorded in prospectively enrolled patients (128 THA and 139 TKA) via an app, which uses the phone's accelerometer. During 6-month follow-up, patients also completed PROMs (the pain numeric rating scale, the Hip Disability and Osteoarthritis Outcome Score Joint Replacement [HOOS JR] and the Knee Injury and Osteoarthritis Outcome Score Joint Replacement [KOOS JR]), and HOOS or KOOS JR quality of life domain via a mobile-enabled web link. Results At least 6 months of follow-up was completed by 65% for THA and 68% for TKA patients. Reasons for non-completion included time commitment, phone battery, app issues, and health complications. Responses from 78% of requested PROMs were returned with 96% of patients returning at least one post-operative PROM. Step data were available from 92% of days from male patients and 86% of days from female patients. The most robust recovery occurred early, within the first 2 months. The groups with higher pre-operative steps were more likely to recover their maximum daily steps at an earlier time point. Correlations between step counts and PROMs scores were modest. Conclusion Assessing large amounts of post-TKA and post-THA step data using mobile technology is feasible. Completion rates were good, making the technology very useful for collecting frequent PROMs. Being unable to ensure that patients always carried their phones limited our analysis of the step counts.

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Section: Methodsmentioning

confidence: 99%

Monitoring Patient Recovery after THA or TKA using Mobile Technology

Lyman

Hidaka

Fields

et al. 2020

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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“…We chose this follow-up period because the MCID/SCB values in the four papers were calculated from baseline to 1-year post-operatively. A study by Mehta et al concluded that PROMs tend to plateau around 3 to 6 months following hip arthroscopy [22]. Since many clinicians agree that recovery after hip arthroscopy for FAIS occurs within 12 to 18 months, 9 to 30 months was a stable range for comparison.…”

Section: Methodsmentioning

confidence: 99%

Reporting Clinical Significance in Hip Arthroscopy: Where Are We Now?

Polascik

Peck

Cepeda

et al. 2020

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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Background Although p values are standard for reporting statistical significance of patient-reported outcome measures (PROMs), the shift toward clinically important outcome values, including minimal clinically important difference (MCID) and substantial clinical benefit (SCB), necessitates re-evaluation of the current literature. Questions/Purposes We sought to answer two questions regarding studies on primary hip arthroscopy performed for the treatment of femoroacetabular impingement syndrome (FAIS). (1) Do such studies reporting statistical significance on common PROMs meet published MCID/SCB thresholds? (2) What proportion of such studies report both statistical and clinical significance? Methods We identified four papers published in two journals defining MCID/SCB values on the modified Harris Hip Score (mHHS), Hip Outcome Score–Activities of Daily Living (HOS-ADL), Hip Outcome Score-Sport (HOS-Sport), international Hip Outcome Tool (iHOT-33), and its short version (iHOT-12) for different groups of FAIS patients undergoing hip arthroscopy. We reviewed these two journals from the dates of publication to the present to identify papers reporting changes in post-operative PROMs. The difference in pre- and post-operative scores on each PROM was calculated and compared to MCID/SCB thresholds. Results Twelve studies were included. Ten studies (83%) evaluated mHHS (90% met MCID, 50% met SCB), seven (58%) evaluated HOS-ADL (100% met MCID/SCB) and HOS-Sport (100% met MCID, 57% met SCB), and one (8%) evaluated iHOT-33 (met MCID/SCB) and iHOT-12 (met MCID). Most studies met MCID and SCB at both 1- and 2-year timepoints. Of the studies evaluated, 50% reported clinical relevance. Conclusions Nearly all studies evaluated met MCID, while fewer met SCB. Only half discussed these clinical measures. It is proposed that all future studies report both statistical and clinical significance as standard best practice.

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“…This feature should be considered for orthopedic interventions, where quantifying the progress can motivate patients to take active roles in their recovery [33]. Mehta et al [34] aligned this idea with reports of positive reinforcement by setting and meeting individual recovery goals following hip arthroplasty. Goal setting is a well-recognized behavior change technique that supports self-regulation skills in the change process [35,36].…”

Section: Principal Findingsmentioning

confidence: 99%

Designing the Optimal Digital Health Intervention for Patients’ Use Before and After Elective Orthopedic Surgery: Qualitative Study

Robinson¹,

Slight²,

Husband³

et al. 2021

J Med Internet Res

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Background Health behavior changes made by patients during the perioperative period can impact the outcomes and success of elective surgeries. However, there remains a limited understanding of how best to support patients during this time, particularly through the use of digital health interventions. Recognizing and understanding the potential unmet needs of elective orthopedic surgery patients is central to motivating healthier behavior change, improving recovery, and optimizing overall surgical success in the short and long term. Objective The aim of this study is to explore patient perspectives on technology features that would help support them to change their lifestyle behaviors during the pre- and postoperative periods, and that could potentially maintain long-term healthy lifestyles following recovery. Methods Semistructured interviews with pre- and postoperative elective orthopedic patients were conducted between May and June 2020 using telephone and video call–based software. Patient perspectives on the use of digital technologies to complement current surgical care and support with lifestyle behavior changes were discussed. Interviews were audio recorded and transcribed verbatim. Reflexive thematic analysis enabled the development of themes from the data, with QSR NVivo software (version 12) facilitating data management. Ethical approval was obtained from the National Health Service Health Research Authority. Results A total of 18 participants were interviewed. Four themes were developed from the data regarding the design and functionality of digital technologies to best support the perioperative journey. These center around an intervention’s ability to incorporate interactive, user-centered features; direct a descriptive and structured recovery; enable customizable, patient-controlled settings; and deliver both general and specific surgical advice in a timely manner. Interventions that are initiated preoperatively and continued postoperatively were perceived as beneficial. Interventions designed with personalized milestones were found to better guide patients through a structured recovery. Individualized tailoring of preparatory and recovery information was desired by patients with previously high levels of physical activity before surgery. The use of personalized progression-based exercises further encouraged physical recovery; game-like rewards and incentives were regarded as motivational for making and sustaining health behavior change. In-built video calling and messaging features offered connectivity with peers and clinicians for supported care delivery. Conclusions Specific intervention design and functionality features can provide better, structured support for elective orthopedic patients across the entire surgical journey and beyond. This study provides much-needed evidence relating to the optimal design and timing of digital interventions for elective orthopedic surgical patients. Findings from this study suggest a desire for personalized perioperative care, in turn, supporting patients to make health behavior changes to optimize surgical success. These findings should be used to influence future co-design projects to enable the design and implementation of patient-focused, tailored, and targeted digital health technologies within modern health care settings.

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Using Mobile Tracking Technology to Visualize the Trajectory of Recovery after Hip Arthroscopy: A Case Report

Cited by 12 publications

References 24 publications

Monitoring Patient Recovery after THA or TKA using Mobile Technology

Monitoring Patient Recovery after THA or TKA using Mobile Technology

Reporting Clinical Significance in Hip Arthroscopy: Where Are We Now?

Designing the Optimal Digital Health Intervention for Patients’ Use Before and After Elective Orthopedic Surgery: Qualitative Study

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