Digital Versus Conventional Rehabilitation After Total Hip Arthroplasty: A Single-Center, Parallel-Group Pilot Study.
Fernando Dias Correia, André Nogueira, Ivo Magalhães and 9 others
PMID 31228176WHAT IT FOUND
Patients using a digital home exercise system after hip replacement recovered mobility and hip movement faster than those receiving conventional in-person physiotherapy.
The digital group had better Timed Up and Go scores at 8 weeks and 6 months, but the study was small and not randomly assigned.
Key findings
01The digital group had significantly faster Timed Up and Go times at 8 weeks (median difference 3.34 seconds) and 6 months (median difference 1.87 seconds) compared to the conventional group.
02Total therapist time was substantially lower for the digital group (mean 6.5 hours) compared to the conventional group (mean 32.1 hours).
03Safety was similar between groups, with no significant difference in adverse events, though 14% of digital patients dropped out due to pain or system adaptation issues.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Allocation was based on geography, not randomization, introducing potential selection bias. Small sample size (66 patients) and pilot design limit statistical power. High refusal rate at screening (58%) suggests a selection bias toward patients more comfortable with technology. 37% of digital patients required caregiver assistance for system setup, highlighting usability challenges for older adults. Ceiling effects in HOOS pain and symptom subscales limit the ability to detect differences in those areas. The study was funded by the company that sells the digital system.
Declared interests
Several authors are employees, shareholders, or honoraria recipients of SWORD Health, the company that developed the digital system used in the study.
The easy way to misread this
Do not interpret this as proof that digital rehab is superior to conventional physiotherapy. The study was not randomized, allocation was based on address, and the sample was small and self-selected. The positive results may be due to confounding factors such as socioeconomic status or technology literacy, rather than the intervention itself.