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Home/Large Joints and Extremities/mymobility® With Apple Watch® May Replace Traditional PT?
Large Joints and Extremities

mymobility® With Apple Watch® May Replace Traditional PT?

October 6, 2021 2 min read Premium comments

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#totalkneearthroplasty#zimmerbiometSecondary#selfdirectedrehabilitation

Physical therapists need not “apply?” A new study has found that using a smartwatch with an app, i.e., a self-directed rehabilitation program using Zimmer Biomet’s mymobility® with Apple Watch®, produced patient outcomes which were similar to traditional physical therapy.

“A Smartwatch Paired With A Mobile Application Provides Postoperative Self-Directed Rehabilitation Without Compromising Total Knee Arthroplasty Outcomes: A Randomized Controlled Trial,” was published in the August 9, 2021 edition of the Journal of Arthroplasty.

Co-author Krishna Tripuraneni, M.D., an orthopedic surgeon at New Mexico Orthopaedics, presented the findings at the recent annual meeting of the American Academy of Orthopaedic Surgeons. Dr. Tripuraneni told OTW: “With new smartwatch- and smartphone-based remote care management platforms like mymobility with Apple Watch, we saw an opportunity to individualize patients’ postoperative care by monitoring recovery metrics and tailoring rehabilitation regimens based on each patient’s unique pace of recovery. We conducted this analysis in total knee arthroplasty patients to determine how postoperative outcomes were impacted by a self-directed rehabilitation program, administered via the mymobility application paired with an Apple Watch.”

The researchers conducted a prospective, randomized, multicenter, controlled trial and organized the patients into three test groups:

  1. control group (traditional physical therapy; 184 patients),
  2. high exercise compliance group (90 patients), and
  3. low exercise compliance group (63 patients).

The team assessed patient-reported outcome measures of knee injury and osteoarthritis outcome scores, joint replacement (Knee Injury and Osteoarthritis Outcome Score, Joint Replacement—KOOS, JR), and EuroQol five-dimension five-level along with range of motion and manipulation rates.

“The KOOS, JR score was statistically lower in the low-compliance group in net change from preoperative scores at 3 months and 6 months than that in the control group; difference was noted at 6 months for the high-compliance group.”

“However, these did not meet the threshold of 8.02 units for KOOS, JR minimal clinically important difference. No differences were seen in patient-reported outcome measures at other time intervals and in manipulation rates or ROM [range of motion],” wrote the authors.

“We found that using a self-directed rehabilitation program using mymobility and an Apple Watch yielded clinically similar outcomes compared to patients who received traditional physical therapy.” Dr. Tripuraneni told OTW, “Patient reported outcomes, range of motion and manipulation under anesthesia rates were not different between a high compliance or low compliance group compared to a control.”

“Smartwatch-based remote care platforms could be viable additions to traditional postsurgical care regimens. It remains to be seen whether platforms such as the current one studied will translate to lower healthcare utilization, in terms of surgeon’s office and physical therapy visits and possibly lower costs.”

React:

Discussion

14
DS
Dr. Sarah MitchellOrthopedic Surgeon · Mayo Clinic

This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?

8
JT
James Thornton, MDSpine Fellow · HSS

Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.

5
RP
R. PatelSports Medicine · Stanford

We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.

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