Use of mobile app to enhance functional outcomes and adherence of home-based rehabilitation program for elderly with hip fracture: A randomized controlled trial.
Kui Ching Cheng, Kin Ming Ken Lau, Andy S K Cheng and 4 others
PMID 37560168WHAT IT FOUND
A mobile app improved exercise adherence in the first month, but did not lead to better walking, mobility, or function than paper handouts at two months.
The study was underpowered due to dropouts, so the lack of functional difference is uncertain.
Key findings
01The mobile app group had significantly better exercise adherence than the control group at one month, but this difference disappeared by two months.
02Both groups improved significantly in walking capacity, mobility, and lower extremity function over two months, but there was no significant difference between the app and paper handout groups.
03Caregiver strain decreased significantly in both groups over two months, with no difference between the app and paper handout groups.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study was severely underpowered because only 39 of the planned 144 participants completed the trial, largely due to dropouts and COVID-19 restrictions. This makes it difficult to rule out small differences between the groups. Participants were not blinded to their allocation, which could influence self-reported outcomes like adherence and function. The follow-up period was only two months, which may be too short to see the long-term benefits of improved adherence on physical performance. The participants had high baseline mobility status, so results may not apply to those who are more dependent or have lower pre-fracture function. Technical issues with the app (installation, screen size) were common and may have affected usability and adherence.
Declared interests
The authors declared no conflicts of interest. The study received no financial support.
The easy way to misread this
Do not conclude that mobile apps are ineffective for functional recovery. The study was underpowered and had a short follow-up, so it cannot definitively rule out benefits. Also, do not assume that higher adherence automatically leads to better functional outcomes, as this relationship was not observed in this trial.