Development of a mobile application to improve exercise accuracy and quality of life in knee osteoarthritis patients: a randomized controlled trial

Satit Thiengwittayaporn, Pichayut Wattanapreechanon, Phraew Sakon, Apatha Peethong, Nantaporn Ratisoontorn, Narattaphol Charoenphandhu, Supiya Charoensiriwath, Satit Thiengwittayaporn, Pichayut Wattanapreechanon, Phraew Sakon, Apatha Peethong, Nantaporn Ratisoontorn, Narattaphol Charoenphandhu, Supiya Charoensiriwath

Abstract

Introduction: Knee Osteoarthritis (OA) is a degenerative joint disease that needs consistent exercise and an accurate understanding of the condition for long-term maintenance. While the accessibility of outpatient care is essential for disease management, many patients lack the resources to receive adequate healthcare. To address this challenge, we developed a not-for-profit interactive mobile application that provides a disease-specific educational background and a structured exercise regimen to patients.

Material and methods: "Rak Kao" (English translation: Love-Your-Knee) mobile application was designed to analyze the questionnaire data to assess the stage of knee OA and generate a personalized recommendation of treatment and exercise type using rule-based and Artificial Intelligence (AI) techniques. A single-blinded study was conducted with patients (n = 82) who were randomly assigned to the mobile application group (M-group) and the handout group (H-group). Patient groups were controlled for age, gender, BMI, onset of pain, grade of disease, education level, and occupation. Accuracy in performance of three prescribed knee exercises (catch-bend-down, stretch-touch-feet, and sit-stretch-hold) was evaluated. Clinical outcomes were evaluated before and after the 4-weeks program to assess the range of motion, symptoms, pain, physical activity, and quality of life via the KOOS and KSS scores.

Results: Completion of the study led to significantly more overall exercise accuracy in the M-group (76.2%) than the H-group (52.5%). Activities of daily life, quality of life, ability to do sports and recreational activities were significantly more improved in the M-group than the H-group (p < .01). No difference in the range of motion between groups. Satisfaction of patients' experience was higher in the M-group than the H-group (p = .001) after the 4-week regimen.

Conclusions: With the better accuracy and outcomes for rehabilitation in the M-group than the H-group, we strongly recommend using our mobile application as a better alternative than handouts for exercises and information for patients with knee OA.

Trial registration: ClinicalTrials.gov: NCT03666585.

Keywords: Knee exercises; Knee osteoarthritis; Mobile application; Rehabilitation; Smartphone application.

Conflict of interest statement

The authors declare that they have no conflict of interest.

© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Figures

Fig. 1
Fig. 1
Overview of mobile application design and criteria that serves OA patients
Fig. 2
Fig. 2
“Love your knee” app modules for education and assessment for the stage of disease
Fig. 3
Fig. 3
Patient enrollment, eligibility, and randomization into H (handout)-group and M (mobile application)-group
Fig. 4
Fig. 4
Instruction of three exercises for H (handout)-group and M (mobile application)-group

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