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Digital Prehabilitation Reduces Length of Stay in Patients Prior to TKA

5 pagesPublished: June 13, 2017

Abstract

Provision of prehabilitation prior to total knee arthroplasty (TKA) through a digital mobile application is a novel concept. Traditionally, prehabilitation is provided face to face by a Physiotherapist. Kwok et al (2015) in a systematic review concluded future research should be directed at methods of prehabilitation that are cost effective method. Our research evaluates a resource effective and cost effective method of delivering prehabilitation. DoironCadrin et al 2016 have reported a randomised control trial protocol involving pre-habilitation through audio-visual software, this protocol still requires a health care practitioners time in real time, whereas our methodology enables multiple patients to be managed simultaneously, optimising health care utility.
Prehabilitation is believed to have multiple benefits for the patients’ recovery and outcome. Prehabilitation may impact on length of stay (LOS) through aspects of Social Cognitive Theory (SCT). A mobile application allows a patient’s exercise participation to be recorded, monitored continuously and progressed drives greater self-efficacy, outcome expectation, self-regulation and motivation which could be a mechanism by which patients receive benefit (Brown et al 2014). Another mechanism may be through lower levels of pain and function in the early period after TJR surgery, as reported in the meta-analysis completed by Wang et al (2016). The primary aim of our research is to determine whether provision of prehabilitation through a mobile digital application impacts inpatient LOS after TKA. The secondary objective is to understand the effect of digital prehabilitation on hospital costs.

Keyphrases: health economic evaluation, Telemedicine, Total knee arthroplasty, Prehabilitation

In: Klaus Radermacher and Ferdinando Rodriguez Y Baena (editors). CAOS 2017. 17th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery, vol 1, pages 214--218

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