An app with remote support achieves better adherence to home exercise programs than paper handouts in people with musculoskeletal conditions: a randomised trial

Lambert, Tara E; Harvey, L A; Avdalis, Christos; Chen, Lydia W.; Jeyalingam, Sayanthinie; Pratt, Carin A; Tatum, Holly J; Bowden, Jocelyn L.; Lucas, Barbara R.

doi:10.1016/j.jphys.2017.05.015

Cited by 152 publications

(151 citation statements)

References 27 publications

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“…which reduced to 52% at week 8, and Conroy et al(3) reported only half of participants adhered to their programme and almost one quarter completed no exercise diaries.Adherence to home-based exercise is affected by factors such as low motivation, pain and past experience of exercise(33). Participants in the active comparator group reported that completing and returning the exercise diaries improved their adherence.…”

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confidence: 99%

Web-based physiotherapy for people affected by multiple sclerosis: a single blind, randomized controlled feasibility study

et al. 2018

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Objective: To examine the feasibility of a trial to evaluate web-based physiotherapy compared to a standard home exercise programme in people with Multiple Sclerosis (MS). Design: Multi-centre, randomised controlled, feasibility study Setting; Three Multiple Sclerosis outpatient centres Participants: Ninety people with Multiple Sclerosis (Expanded Disability Disease Scale 4-6.5), Interventions: Participants were randomised, to a 6 month individualised, home exercise programme delivered via web-based physiotherapy (n=45) (intervention) or a sheet of exercises (n=45) (active comparator). Main outcome measures: Outcome measures (0, 3, 6 and 9 months) included adherence, 2min walk test, 25ft walk, Berg Balance Scale, physical activity and healthcare resource use. Interviews were undertaken with 24 participants and 3 physiotherapists. Results: Almost 25% of people approached agreed to take part. No intervention-related adverse events were recorded. Adherence was 40-63% and 53-71% in the web-based physiotherapy and comparator groups. There was no difference in the 2min walk test between groups at baseline (Intervention-80.4(33.91)m, Comparator-70.6(31.20)m) and no change over time (at 6 months Intervention-81.6(32.75)m, Comparator 74.8(36.16)m). There were no significant changes over time in other outcome measures except the EQ-5D at 6 months which improved in the active comparator group. For a difference of 8(17.4)m in the 2min walk test between groups 76 participants/group would be required (80% power, p>0.05) for a future randomised controlled trial. 3 Conclusion: no changes were found in the majority of outcome measures over time. This study was acceptable and feasible by participants and physiotherapists. An adequately powered study needs 160 participants.

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confidence: 99%

Web-based physiotherapy for people affected by multiple sclerosis: a single blind, randomized controlled feasibility study

et al. 2018

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“…With respect to motivation, patients often need extra support (e.g. by a mobile app) 41 to continue exercising. 42 Serious games also have the potential to improve the motivation to exercise, 24,25 but this has mostly been shown in studies lasting only 4-6 weeks.…”

Section: Discussionmentioning

confidence: 99%

Serious Gaming to Support Exercise Therapy for Patients with Chronic Nonspecific Low Back Pain: A Feasibility Study

Matheve

Claes

Olivieri

et al. 2018

Games for Health Journal

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“…However, more data is required to thoroughly evaluate this. Motivation to complete independent exercises is a known issue in physiotherapy practice (for both adults and children) and technological supports are showing promising results in improving compliance [18]. The particular value added by an embodied artificial agent such as NAO versus a virtual graphical body (for example, a video or animation) has also been previously explored, with evidence suggesting that participants perceive more social presence when interacting with a robot than with other virtual agents [19,45], which, in turn, may lead to heightened motivation and emotional connection with the aid.…”

Section: Discussionmentioning

confidence: 99%

Adapting a General-Purpose Social Robot for Paediatric Rehabilitation through In Situ Design

Carrillo

Butchart

Knight

et al. 2018

J. Hum.-Robot Interact.

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Socially assistive robots (SARs) offer great promise for improving outcomes in paediatric rehabilitation. However, the design of software and interactive capabilities for SARs must be carefully considered in the context of their intended clinical use. While previous work has explored specific roles and functionalities to support paediatric rehabilitation, few have considered the design of such capabilities in the context of ongoing clinical deployment. In this article, we present a two-phase in situ design process for SARs in health care, emphasising stakeholder engagement and on-site development. We explore this in the context of developing the humanoid social robot NAO as a socially assistive rehabilitation aid for children with cerebral palsy. We present and evaluate our design process, outcomes achieved, and preliminary results from ongoing clinical testing with 9 patients and 5 therapists over 14 sessions. We argue that our in situ design methodology has been central to the rapid and successful deployment of our system. Rehabilitation outcomes rely critically on patients adhering to a prescribed set of rehabilitation exercises [38]. When those patients are children, maintaining compliance and focus while performing what can often be tiring, uncomfortable, and repetitive exercise programs presents a significant challenge [30,34]. While therapists and caregivers are well equipped with skills and experience to maintain a child's motivation, this takes considerable time and resources [24]. Therapists are not always able to attend each prescribed exercise session and, even when present, results are not always positive.Socially assistive robots (SARs) are increasingly being considered to support a range of health care delivery needs. SARs provide assistance primarily through social interaction and engagement [8], that is, children suffering form serious illness [1]. SARs have shown promising results for improving mood, reducing stress, and encouraging communication for children on the autism spectrum [35], in rehabilitation [4,37], for encouraging exercise in older adults [7], and in poststroke rehabilitation [44].Paediatric rehabilitation presents an ideal context for the application of SARs. Previous work suggests that SARs may provide therapeutic benefits for patients through increased focus and compliance [9,17]. However, no formal clinical evaluation of the therapeutic benefits of SARs for rehabilitation currently exists. This requires development beyond proof-of-concept, with clear clinical-use cases identified. While previous work has explored specific roles and functionalities to support paediatric rehabilitation (e.g., [2,4,20,37]) few have considered the design of such capabilities in the context of ongoing clinical deployment. Addressing this gap is critical to understanding the clinical context that SARs must operate in and for establishing the long-term legitimacy of SARs as effective and usable therapeutic aids with therapists and caregivers.We are developing software to adapt the humanoid robot NAO ...

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An app with remote support achieves better adherence to home exercise programs than paper handouts in people with musculoskeletal conditions: a randomised trial

Cited by 152 publications

References 27 publications

Web-based physiotherapy for people affected by multiple sclerosis: a single blind, randomized controlled feasibility study

Web-based physiotherapy for people affected by multiple sclerosis: a single blind, randomized controlled feasibility study

Serious Gaming to Support Exercise Therapy for Patients with Chronic Nonspecific Low Back Pain: A Feasibility Study

Adapting a General-Purpose Social Robot for Paediatric Rehabilitation through In Situ Design

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