App-based supplemental exercise in rehabilitation, adherence, and effect on outcomes: a randomized controlled trial

Area of Science:

• Rehabilitation Medicine
• Digital Health Interventions
• Clinical Exercise Physiology

Background:

• Sub-acute rehabilitation settings often involve physiotherapy to improve patient function.
• Integrating digital tools like mobile applications offers potential for supplemental exercise.
• Assessing the efficacy and adoption of such interventions is crucial for optimizing patient care.

Purpose of the Study:

• To evaluate the uptake of an app-based supplemental exercise program within inpatient sub-acute rehabilitation.
• To determine the impact of this app-based program on patients' length of stay and functional recovery.
• To compare outcomes against usual care physiotherapy.

Main Methods:

• A randomized controlled trial design was employed with random allocation and blinded assessors.
• 144 participants with mixed diagnoses (orthopaedic, neurological, reconditioning) were included.
• The intervention group received usual care physiotherapy plus an app-based exercise program; the control group received usual care only.

Main Results:

• The intervention group achieved a mean daily supplementary exercise dose of 7 minutes or 49 repetitions via the app.
• No statistically significant differences were observed between groups regarding length of stay (MD: -0.5 days, 95% CI: -3.2 to 2.2).
• Secondary functional outcomes, including walking speed and disability levels, also showed no significant between-group differences.

Conclusions:

• Participants in the intervention group demonstrated a low but consistent daily adherence to the supplemental app-based exercise regimen.
• The addition of the app-based exercise program to usual care physiotherapy did not yield significant improvements in length of stay or functional outcomes.
• Further research may be needed to optimize digital exercise interventions for rehabilitation settings.