A chatbot tool on a smart mobile device to promote adherence to home rehabilitation after total knee replacement: A
José Pérez-Maletzki1, Sergio Roig-Casasús2, Beatriz Díaz-Díaz3
1Group of Physiotherapy in the Ageing Processes: Social and Health-care Strategies, Departament de Fisioteràpia, Universitat de València, Carrer de Gascó Oliag, 5, El Pla del Real, Valencia 46010, Spain; Universidad Europea de Valencia, Departamento de Fisioterapia, Passeig de l´Albereda, 7, Valencia 46010, Spain.
Objectives:
To determine the effectiveness of using an automated chatbot to promote adherence to home rehabilitation following total knee replacement surgery. Additionally, exploring the impact on functionality, pain, and physical activity.
Design:
Two-armed randomized controlled trial.
Setting:
University hospital in Valencia, Spain.
Patients:
Ninety-one participants following total knee replacement surgery.
Interventions:
Participants were randomly assigned to standard care or an experimental group (home rehabilitation supervised via chatbot).
Main Outcome Measures:
The primary outcome measure was adherence to the intervention, defined as completing at least 80 % of the prescribed sessions within three months after surgery. Secondary outcomes included functionality, pain, and physical activity. Additionally, the system's usability, safety, and feasibility were evaluated.
Results:
Adherence rate was 89 % (SD 31 %) in the experimental group compared to 74 % (SD 52 %) in the control group. The usability, safety, and feasibility scores, as measured by the System Usability Scale, were 80.4 (SD 36.6; range 49-100). Significant between-group differences were identified in functionality, as measured by the Western Ontario and McMaster University Osteoarthritis Index (-2; IQR - 7 to 4) and the Five Times Sit-to-Stand Test (-0.6; IQR - 2.9 to 1.7). No significant differences were observed for the Knee Range of Motion or Visual Analogue Scale of Pain.
Conclusions:
An automated chatbot tool effectively promotes adherence to early postoperative home rehabilitation in patients undergoing total knee replacement surgery. This approach has increased functional benefits, although it did not provide any benefits in terms of pain relief.
Clinical Trial Registration Number:
NCT05363137. CONTRIBUTION OF THE PAPER.
