Virtual Tools to Enable Management of Knee Osteoarthritis

Abstract

Purpose of review There is increasing recognition that virtual tools, enabled by the internet and telecommunications technology, can increase access to health care. We review evidence about the clinical effectiveness and acceptability of telephone-delivered and videoconferencing clinician consultations, websites and internet-delivered programs, and SMS and mobile applications in enabling the management of people with knee osteoarthritis (OA). We discuss barriers to using virtual tools and suggest strategies to facilitate implementation in clinical settings. Recent findings An increasing number of systematic reviews, meta-analyses, and clinical trials provide evidence showing the effectiveness of virtual tools for improving knee OA management. Qualitative research shows that virtual tools increase patient access to knee OA care, are generally acceptable and convenient for patients, but can be associated with barriers to use from patient and clinician perspectives. Summary Virtual tools offer new opportunities to enable people with knee OA to manage their condition and receive care that may otherwise be difficult or not possible to access. Telephone calls and videoconferencing can be used for real-time synchronous consultations between clinicians and patients, increasing the geographic reach of health services. Websites and internet-based programs can be used to educate patients about their condition, as well as deliver exercise, weight management, and psychological interventions. Mobile apps can monitor and track OA symptoms, exercise, and physical activity, while SMS can facilitate positive behaviour changes for self-management over the long-term when sustained clinician contact may not be possible.

Remote and In-person Supervised Exercise in Patients with Knee Osteoarthritis (RISE-KOA): study protocol for a non-inferiority randomized controlled trial.

“…Previously published studies or those in development have explored the effectiveness of remote exercises for patients with knee OA using video calls for the prescription; however, the supervision throughout the entire treatment in this format remains underinvestigated [61-63]. Thus, although telerehabilitation is an attractive mode and cost-effective strategy for delivering treatment equal to traditional face-to-face rehabilitation, studies focusing primarily on the comparability of supervised exercise remotely using video calls or in-person in patients with knee OA are scarce [29]. In this sense, our study aims to ll this gap in the literature, offering alternative ways for delivering the core treatment for knee OA.…”

“…From patients' and physiotherapists' perspectives, video calls are considered viable and well-evaluated real-time therapeutic intervention tools [27,28]. This resource is commonly used for telehealth consultations and is considered as effective as face-to-face outpatient consultations for managing patients with knee OA [29]. In this context, adopting telerehabilitation into clinical practice is a promising way to reduce costs and expand access to treatment for patients with knee OA [26,30].…”

“…A non-inferiority randomized controlled trial showed that periodized circuiting training via recording videos or face-to-face resulted in equivalent effects for pain intensity, physical function, muscle strength, pain catastrophizing, thigh composition, intermuscular adipose tissue, and muscle architecture [18]. In this context, a gap in the literature is whether fully supervised muscle-strengthening exercises by video calls are non-inferior to in-person in conditionspeci c PROMs, psychological well-being, functional performance, and quadriceps femoris architecture [29]. Also, this is the rst non-inferiority trial to investigate if remote or in-person supervision modality is equally effective in repercussions on psychological well-being, sleep quality, and quadriceps muscle quality measured by echo intensity.…”

Using SUpported Motivational InTerviewing (SUMIT) to increase physical activity for people with knee osteoarthritis: a pilot, feasibility randomised controlled trial

“…Digital support tools for osteoarthritis are emerging as a cost-effective approach to provide information and education, and assist people with osteoarthritis to engage with prescribed exercise to improve patient outcomes 20 21. In addition to behaviour change interventions, such as motivational interviewing, they can be used to monitor and/or promote physical activity, and may help to increase physical activity 22. However, the influence of digital support tools on physical activity behaviour change is unknown 22…”

“…In addition to behaviour change interventions, such as motivational interviewing, they can be used to monitor and/or promote physical activity, and may help to increase physical activity 22. However, the influence of digital support tools on physical activity behaviour change is unknown 22…”