A Cyber-Physical System for Near Real-Time Monitoring of At-Home Orthopedic Rehabilitation and Mobile-Based Provider-Patient Communications to Improve Adherence: Development and Formative Evaluation

被引：4

作者：

Stevens, Timothy ^{[1
]}

McGinnis, Ryan S. ^{[2
]}

Hewgill, Blake ^{[2
]}

Choquette, Rebecca H. ^{[3
]}

Tourville, Timothy W. ^{[3
,4
]}

Harvey, Jean ^{[5
]}

Lachapelle, Richard ^{[6
]}

Beynnon, Bruce D. ^{[3
]}

Toth, Michael J. ^{[3
,6
,7
]}

Skalka, Christian ^{[1
]}

机构：

[1] Univ Vermont, Dept Comp Sci, Burlington, VT 05405 USA

[2] Univ Vermont, Dept Elect & Biomed Engn, Burlington, VT 05405 USA

[3] Univ Vermont, Dept Orthoped & Rehabil, Burlington, VT 05405 USA

[4] Univ Vermont, Dept Rehabil & Movement Sci, Burlington, VT 05405 USA

[5] Univ Vermont, Dept Nutr & Food Sci, Burlington, VT 05405 USA

[6] Univ Vermont, Dept Mol Physiol & Biophys, Burlington, VT 05405 USA

[7] Univ Vermont, Dept Med, Hlth Sci Res Facil Rm 126B,149 Beaumont Ave, Burlington, VT 05405 USA

来源：

JMIR HUMAN FACTORS | 2020年 / 7卷 / 02期

关键词：

device use tracking; internet of things; neuromuscular electrical stimulation; exercise; smart devices; mHealth; rehabilitation; mobile health; digital health; CRUCIATE LIGAMENT RECONSTRUCTION; NEUROMUSCULAR ELECTRICAL-STIMULATION; TOTAL KNEE ARTHROPLASTY; MUSCLE STRENGTH; CONTROLLED-TRIAL; ANTERIOR; QUADRICEPS; ATROPHY;

D O I：

10.2196/16605

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Background: Knee extensor muscle performance is reduced after lower extremity trauma and orthopedic surgical interventions. At-home use of neuromuscular electrical stimulation (NMES) may improve functional recovery, but adherence to at-home interventions is low. Greater benefits from NMES may be realized with closer monitoring of adherence to at-home prescriptions and more frequent patient-provider interactions. Objective: This study aimed to develop a cyber-physical system to monitor at-home adherence to NMES prescription and facilitate patient-provider communications to improve adherence in near real time. Methods: The RehabTracker cyber-physical system was developed to accomplish this goal and comprises four components: (1) hardware modifications to a commercially available NMES therapy device to monitor device use and provide Bluetooth functionality; (2) an iPhone Operating System-based mobile health (mHealth) app that enables patient-provider communications in near real time; (3) a clinician portal to allow oversight of patient adherence with device use; and (4) a back-end server to store data, enable adherence analysis, and send automated push notifications to the patient. These four elements were designed to be fully compliant with the Health Insurance Portability and Accountability Act. The system underwent formative testing in a cohort of patients following anterior cruciate ligament rupture (n=7) to begin to assess face validity. Results: Compared with the NMES device software-tracked device use, the RehabTracker system recorded 83% (40/48) of the rehabilitation sessions, with 100% (32/32) of all sessions logged by the system in 4 out of 7 patients. Inpatients for whom tracking of automated push notifications was enabled, 100% (29/29) of the push notifications sent by the back-end server were received by the patient. Process, hardware, and software issues contributing to these inaccuracies are detailed. Conclusions: RehabTracker represents a promising mHealth app for tracking and improving adherence with at-home NMES rehabilitation programs and warrants further refinement and testing.

引用

页数：14