A Virtual Assistant to Guide Early Postoperative Rehabilitation after Reverse Shoulder Arthroplasty: A Pilot Randomized Trial.

José-María Blasco, Marta Navarro-Bosch, José-Enrique Aroca-Navarro, David Hernández-Guillén, Pau Puigcerver-Aranda, Sergio Roig-Casasús
Author Information
  1. José-María Blasco: Group in Physiotherapy of the Ageing Processes-Social and Healthcare Strategies, Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain. ORCID
  2. Marta Navarro-Bosch: Orthopedic and Trauma Surgery Service, Hospital Universitari i Politècnic La Fe de València, 46026 Valencia, Spain.
  3. José-Enrique Aroca-Navarro: Orthopedic and Trauma Surgery Service, Hospital Universitari i Politècnic La Fe de València, 46026 Valencia, Spain.
  4. David Hernández-Guillén: Group in Physiotherapy of the Ageing Processes-Social and Healthcare Strategies, Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain. ORCID
  5. Pau Puigcerver-Aranda: Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain.
  6. Sergio Roig-Casasús: Group in Physiotherapy of the Ageing Processes-Social and Healthcare Strategies, Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain.

Abstract

INTRODUCTION: Rehabilitation can improve outcomes after reverse shoulder arthroplasty (RSA). However, low adherence to rehabilitation and compliance rates are some of the main barriers. To address this public health issue, the goal of this research was to pilot test and evaluate the effectiveness of a chatbot to promote adherence to home rehabilitation in patients undergoing RSA.
METHODS: A randomized pilot trial including patients undergoing RSA and early postoperative rehabilitation was performed. The control group received standard home rehabilitation; the experimental group received the same intervention supervised with a chatbot, with automated interactions that included messages to inform, motivate, and remember the days and exercises for 12 weeks. Compliance with rehabilitation and clinical measures of shoulder function, pain, and quality of life were assessed.
RESULTS: 31 patients (17 experimental) with an average age of 70.4 (3.6) completed the intervention. Compliance was higher in the experimental group (77% vs. 65%; OR95% = 2.4 (0.5 to 11.4)). Statistically significant between-group differences with a CI of 95% were found in the QuickDASH questionnaire and self-reported quality of life. No differences were found in the rest of the measures.
CONCLUSIONS: This pilot study suggests that the chatbot tool can be useful in promoting compliance with early postoperative home rehabilitation in patients undergoing RSA. Future randomized trials with adequate power are warranted to determine the clinical impact of the proposal.

Keywords

References

  1. BMC Med Res Methodol. 2010 Jan 06;10:1 [PMID: 20053272]
  2. Arch Orthop Trauma Surg. 2023 Jul;143(7):4049-4063 [PMID: 36436065]
  3. J Shoulder Elbow Surg. 2018 Nov;27(11):1946-1952 [PMID: 29934280]
  4. Curr Rev Musculoskelet Med. 2023 Apr;16(4):145-153 [PMID: 36867393]
  5. Acta Ortop Bras. 2019 Sep-Oct;27(5):269-272 [PMID: 31839737]
  6. J Orthop Sports Phys Ther. 2019 May;49(5):337-346 [PMID: 31021690]
  7. Telemed J E Health. 2004 Summer;10(2):147-54 [PMID: 15319044]
  8. J Neuroeng Rehabil. 2014 Jul 03;11:108 [PMID: 24996956]
  9. J Rehabil Med. 2013 Apr;45(4):392-6 [PMID: 23474735]
  10. J Bone Joint Surg Am. 2007 Jul;89(7):1476-85 [PMID: 17606786]
  11. J Shoulder Elbow Surg. 2013 Dec;22(12):1650-5 [PMID: 23850308]
  12. Clin Rehabil. 2022 Nov;36(11):1539-1562 [PMID: 35733369]
  13. Healthcare (Basel). 2023 Mar 19;11(6): [PMID: 36981544]
  14. J Bone Joint Surg Am. 2008 Dec;90(12):2606-15 [PMID: 19047705]
  15. J Shoulder Elbow Surg. 2005 Sep-Oct;14(5):524-8 [PMID: 16194746]
  16. Physiotherapy. 2012 Sep;98(3):211-6 [PMID: 22898577]
  17. J Arthroplasty. 2001 Jun;16(4):483-6 [PMID: 11402412]
  18. Patient Prefer Adherence. 2015 Jul 01;9:893-7 [PMID: 26170639]
  19. Am J Phys Med Rehabil. 2019 Aug;98(8):671-676 [PMID: 31318747]
  20. J Shoulder Elbow Surg. 2006 Sep-Oct;15(5):527-40 [PMID: 16979046]
  21. Scand J Occup Ther. 2023 Jan;30(1):14-20 [PMID: 35245989]
  22. Games Health J. 2014 Dec;3(6):351-65 [PMID: 26192642]
  23. Man Ther. 2010 Jun;15(3):220-8 [PMID: 20163979]
  24. J Med Internet Res. 2019 Jun 18;21(6):e12505 [PMID: 31215517]
  25. Arthritis Care Res (Hoboken). 2020 May;72(5):661-668 [PMID: 30908867]
  26. J Sport Rehabil. 2011 Feb;20(1):115-28 [PMID: 21411827]
  27. Shoulder Elbow. 2017 Jul;9(3):212-222 [PMID: 28588662]
  28. Rev Bras Ortop. 2017 May 04;52(3):298-302 [PMID: 28702387]
  29. JMIR Rehabil Assist Technol. 2017 Jul 21;4(2):e7 [PMID: 28733271]
  30. J Shoulder Elbow Surg. 2009 Nov-Dec;18(6):920-6 [PMID: 19297202]

Grants

  1. PID2020-115825RA-I00/Agencia Estatal de Investigación
  2. 2022/Sociedad Española de Cirugía de Hombro y Codo (SECHC)

Word Cloud

Created with Highcharts 10.0.0rehabilitationRSAchatbotpatientsshoulderpilothomeundergoinggroupexperimental4RehabilitationcanreversearthroplastyadherencecompliancerandomizedearlypostoperativereceivedinterventionComplianceclinicalmeasuresqualitylifedifferencesfoundINTRODUCTION:improveoutcomesHoweverlowratesmainbarriersaddresspublichealthissuegoalresearchtestevaluateeffectivenesspromoteMETHODS:trialincludingperformedcontrolstandardsupervisedautomatedinteractionsincludedmessagesinformmotivaterememberdaysexercises12weeksfunctionpainassessedRESULTS:3117averageage7036completedhigher77%vs65%OR95%=20511Statisticallysignificantbetween-groupCI95%QuickDASHquestionnaireself-reportedrestCONCLUSIONS:studysuggeststoolusefulpromotingFuturetrialsadequatepowerwarranteddetermineimpactproposalVirtualAssistantGuideEarlyPostoperativeReverseShoulderArthroplasty:PilotRandomizedTrialsmartphonevirtualassistant

Similar Articles

Cited By (1)