Digital Rehabilitation for Acute Ankle Sprains: Prospective Longitudinal Cohort Study

Detalhes bibliográficos
Autor(a) principal: Correia, Fernando D.
Data de Publicação: 2021
Outros Autores: Molinos, Maria, Neves, Carlos, Janela, Dora, Carvalho, Diana, Luis, Sara, Francisco, Gerard E., Laíns, Jorge, Bento, Virgilio
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10316/104827
https://doi.org/10.2196/31247
Resumo: Background: Ankle sprains are one of the most prevalent soft-tissue injuries worldwide. Physical therapy, especially progressive exercise, has proven effective in improving function, while preventing recurrence. Objective: We aim to present the results of a fully remote and digitally guided rehabilitation program for acute ankle sprains. Methods: We performed a prospective longitudinal cohort study of individuals eligible for workers’ compensation, who were referred for digital rehabilitation therapy for a sprained ankle. Therapeutic exercise sessions were to be performed independently by the patient at home using the biofeedback device provided by SWORD Health. Primary endpoints were the change in self-reported Numerical Pain Rating Scale (NPRS) and Foot and Ankle Ability Measure–activities of daily living (FAAM–ADL) and FAAM–Sports scores. Participants were assessed at baseline, end of the program, and 6 months after program completion. Secondary outcomes included digital therapy dosage, pain and fatigue during sessions, and satisfaction. Results: In total, 93 (89.4%) patients completed the program and 79 (76.0%) were available for follow-up. Changes in the primary outcomes between baseline and the 6-month follow-up were both significant (P<.001) and clinically meaningful: mean difference of –2.72 points (95% CI –3.31 to –2.13) on the NPRS (49.8% reduction), 21.7 points (95% CI 17.13-26.27) on the FAAM–ADL (41.1% increase), and 37.8 points (95% CI 30.45-45.15) on the FAAM-Sports (151.8% increase). Longer waiting periods between the accident date and treatment initiation were found to negatively impact functional status at baseline and at the end of the program, triggering an extension in the program duration. The total training volume (12.5 hours, SD 10.5 hours) was similar to that of other interventions for ankle sprains, but the dosage per week was much higher (2.4 hours per week, SD 0.87 hours per week). The mean patient satisfaction score was 8.8 (SD 1.57) out of 10. Among program completers, 83.9% attained full recovery and were discharged with no residual disability. Conclusions: Being far less demanding in terms of human resources, the digital program presented constituted a viable, clinically effective, and convenient solution for ankle sprain rehabilitation, particularly during the pandemic. This is the first study presenting a fully remote home-based rehabilitation program for acute ankle sprains, with patients achieving sustained long-term results. This was a prospective cohort study and, as such, did not include a control group, but the results appear comparable to those published for face-to-face interventions. Trial Registration: ClinicalTrials.gov NCT04819022; https://clinicaltrials.gov/ct2/show/NCT04819022
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spelling Digital Rehabilitation for Acute Ankle Sprains: Prospective Longitudinal Cohort Studyacute ankle sprainsphysical rehabilitationhome-based digital rehabilitationdigital therapyrehabilitationspraindigital healththerapyrehabilitationprospectivelongitudinalcohortanklesoft tissuephysical therapypainoutcomefatigueBackground: Ankle sprains are one of the most prevalent soft-tissue injuries worldwide. Physical therapy, especially progressive exercise, has proven effective in improving function, while preventing recurrence. Objective: We aim to present the results of a fully remote and digitally guided rehabilitation program for acute ankle sprains. Methods: We performed a prospective longitudinal cohort study of individuals eligible for workers’ compensation, who were referred for digital rehabilitation therapy for a sprained ankle. Therapeutic exercise sessions were to be performed independently by the patient at home using the biofeedback device provided by SWORD Health. Primary endpoints were the change in self-reported Numerical Pain Rating Scale (NPRS) and Foot and Ankle Ability Measure–activities of daily living (FAAM–ADL) and FAAM–Sports scores. Participants were assessed at baseline, end of the program, and 6 months after program completion. Secondary outcomes included digital therapy dosage, pain and fatigue during sessions, and satisfaction. Results: In total, 93 (89.4%) patients completed the program and 79 (76.0%) were available for follow-up. Changes in the primary outcomes between baseline and the 6-month follow-up were both significant (P<.001) and clinically meaningful: mean difference of –2.72 points (95% CI –3.31 to –2.13) on the NPRS (49.8% reduction), 21.7 points (95% CI 17.13-26.27) on the FAAM–ADL (41.1% increase), and 37.8 points (95% CI 30.45-45.15) on the FAAM-Sports (151.8% increase). Longer waiting periods between the accident date and treatment initiation were found to negatively impact functional status at baseline and at the end of the program, triggering an extension in the program duration. The total training volume (12.5 hours, SD 10.5 hours) was similar to that of other interventions for ankle sprains, but the dosage per week was much higher (2.4 hours per week, SD 0.87 hours per week). The mean patient satisfaction score was 8.8 (SD 1.57) out of 10. Among program completers, 83.9% attained full recovery and were discharged with no residual disability. Conclusions: Being far less demanding in terms of human resources, the digital program presented constituted a viable, clinically effective, and convenient solution for ankle sprain rehabilitation, particularly during the pandemic. This is the first study presenting a fully remote home-based rehabilitation program for acute ankle sprains, with patients achieving sustained long-term results. This was a prospective cohort study and, as such, did not include a control group, but the results appear comparable to those published for face-to-face interventions. Trial Registration: ClinicalTrials.gov NCT04819022; https://clinicaltrials.gov/ct2/show/NCT04819022JMIR Publications Inc.2021-09-30info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttp://hdl.handle.net/10316/104827http://hdl.handle.net/10316/104827https://doi.org/10.2196/31247eng2369-2529Correia, Fernando D.Molinos, MariaNeves, CarlosJanela, DoraCarvalho, DianaLuis, SaraFrancisco, Gerard E.Laíns, JorgeBento, Virgilioinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-01-25T21:59:32Zoai:estudogeral.uc.pt:10316/104827Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T21:21:28.234523Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Digital Rehabilitation for Acute Ankle Sprains: Prospective Longitudinal Cohort Study
title Digital Rehabilitation for Acute Ankle Sprains: Prospective Longitudinal Cohort Study
spellingShingle Digital Rehabilitation for Acute Ankle Sprains: Prospective Longitudinal Cohort Study
Correia, Fernando D.
acute ankle sprains
physical rehabilitation
home-based digital rehabilitation
digital therapy
rehabilitation
sprain
digital health
therapy
rehabilitation
prospective
longitudinal
cohort
ankle
soft tissue
physical therapy
pain
outcome
fatigue
title_short Digital Rehabilitation for Acute Ankle Sprains: Prospective Longitudinal Cohort Study
title_full Digital Rehabilitation for Acute Ankle Sprains: Prospective Longitudinal Cohort Study
title_fullStr Digital Rehabilitation for Acute Ankle Sprains: Prospective Longitudinal Cohort Study
title_full_unstemmed Digital Rehabilitation for Acute Ankle Sprains: Prospective Longitudinal Cohort Study
title_sort Digital Rehabilitation for Acute Ankle Sprains: Prospective Longitudinal Cohort Study
author Correia, Fernando D.
author_facet Correia, Fernando D.
Molinos, Maria
Neves, Carlos
Janela, Dora
Carvalho, Diana
Luis, Sara
Francisco, Gerard E.
Laíns, Jorge
Bento, Virgilio
author_role author
author2 Molinos, Maria
Neves, Carlos
Janela, Dora
Carvalho, Diana
Luis, Sara
Francisco, Gerard E.
Laíns, Jorge
Bento, Virgilio
author2_role author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Correia, Fernando D.
Molinos, Maria
Neves, Carlos
Janela, Dora
Carvalho, Diana
Luis, Sara
Francisco, Gerard E.
Laíns, Jorge
Bento, Virgilio
dc.subject.por.fl_str_mv acute ankle sprains
physical rehabilitation
home-based digital rehabilitation
digital therapy
rehabilitation
sprain
digital health
therapy
rehabilitation
prospective
longitudinal
cohort
ankle
soft tissue
physical therapy
pain
outcome
fatigue
topic acute ankle sprains
physical rehabilitation
home-based digital rehabilitation
digital therapy
rehabilitation
sprain
digital health
therapy
rehabilitation
prospective
longitudinal
cohort
ankle
soft tissue
physical therapy
pain
outcome
fatigue
description Background: Ankle sprains are one of the most prevalent soft-tissue injuries worldwide. Physical therapy, especially progressive exercise, has proven effective in improving function, while preventing recurrence. Objective: We aim to present the results of a fully remote and digitally guided rehabilitation program for acute ankle sprains. Methods: We performed a prospective longitudinal cohort study of individuals eligible for workers’ compensation, who were referred for digital rehabilitation therapy for a sprained ankle. Therapeutic exercise sessions were to be performed independently by the patient at home using the biofeedback device provided by SWORD Health. Primary endpoints were the change in self-reported Numerical Pain Rating Scale (NPRS) and Foot and Ankle Ability Measure–activities of daily living (FAAM–ADL) and FAAM–Sports scores. Participants were assessed at baseline, end of the program, and 6 months after program completion. Secondary outcomes included digital therapy dosage, pain and fatigue during sessions, and satisfaction. Results: In total, 93 (89.4%) patients completed the program and 79 (76.0%) were available for follow-up. Changes in the primary outcomes between baseline and the 6-month follow-up were both significant (P<.001) and clinically meaningful: mean difference of –2.72 points (95% CI –3.31 to –2.13) on the NPRS (49.8% reduction), 21.7 points (95% CI 17.13-26.27) on the FAAM–ADL (41.1% increase), and 37.8 points (95% CI 30.45-45.15) on the FAAM-Sports (151.8% increase). Longer waiting periods between the accident date and treatment initiation were found to negatively impact functional status at baseline and at the end of the program, triggering an extension in the program duration. The total training volume (12.5 hours, SD 10.5 hours) was similar to that of other interventions for ankle sprains, but the dosage per week was much higher (2.4 hours per week, SD 0.87 hours per week). The mean patient satisfaction score was 8.8 (SD 1.57) out of 10. Among program completers, 83.9% attained full recovery and were discharged with no residual disability. Conclusions: Being far less demanding in terms of human resources, the digital program presented constituted a viable, clinically effective, and convenient solution for ankle sprain rehabilitation, particularly during the pandemic. This is the first study presenting a fully remote home-based rehabilitation program for acute ankle sprains, with patients achieving sustained long-term results. This was a prospective cohort study and, as such, did not include a control group, but the results appear comparable to those published for face-to-face interventions. Trial Registration: ClinicalTrials.gov NCT04819022; https://clinicaltrials.gov/ct2/show/NCT04819022
publishDate 2021
dc.date.none.fl_str_mv 2021-09-30
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10316/104827
http://hdl.handle.net/10316/104827
https://doi.org/10.2196/31247
url http://hdl.handle.net/10316/104827
https://doi.org/10.2196/31247
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 2369-2529
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv JMIR Publications Inc.
publisher.none.fl_str_mv JMIR Publications Inc.
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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