Osteoarthritis Clinical Trial
Official title:
Comparative Effectiveness of an Activity-Specific Monitoring Device (StepRite) on Short Term Outcomes in Adults After Total Knee Arthroplasty
The purpose of this study is to compare the short-term changes in gait parameters and functional outcomes after total knee arthroplasty between those who use the StepRite device and those who follow a standard therapy program without the device.
Total Knee Arthroplasty (TKA) is a procedure commonly used in severe degeneration of the
knee joint due to osteoarthritis. With an increasing number of TKA's performed in a
population that is aging during a time where the amount of healthcare dollars allotted to
rehabilitation is declining, there is a need to develop remote monitoring of rehabilitation
and to engage and optimize self-management of recovery.
Current management of TKA recovery is typically performed in the out-patient setting and is
highly protocol driven. A typical case might be seen by the physical therapist 2-3x/week for
8-10 weeks to perform specific exercises and to monitor progress (i.e. compliance with range
of motion (ROM) and strengthening exercises). One recent study suggested that variation in
patients' independent exercise and activity after arthroplasty surgery may contribute to
variable functional gains.
Telerehabilitation is an emerging method of delivering healthcare. It is likely to become
more prevalent as technology improves and funding for clinic appointments diminishes. Recent
studies have shown that telerehabilitation can be as effective as conventional treatment, as
is well tolerated by both patients and healthcare professionals.
The StepRite system developed by MedHab (http://www.medhab.com/) allows the physical
therapist to monitor physical activity and exercise remotely, thereby reducing the need for
frequent out-patient visits. A thin insole placed inside the shoe measures foot contact
pressure and a small device attached to the shoe measures acceleration. This information is
translated into quantitative feedback about exercise compliance and performance measures
comparing the surgical side with the non-surgical side. Real time feedback during exercise
and weight-bearing activities is provided to the patient, and a HIPAA secured user interface
website also displays this information in an online dashboard for both physical therapists
and the physician.
Given the potential for improving patient engagement with rehabilitation, this study
proposes a treatment model which includes monitoring activity outside of the clinic using
the StepRite device and using a combination of outpatient appointments and remote
consultations with therapists.
Hypothesis
Patients who use the device post-surgery will demonstrate superior short-term improvements
(i.e. 6 months post TKA) with respect to self-reported functional outcomes and gait
parameters, compared to a control group who does not use the device.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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