Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Feb 26;8(2):e16403.
doi: 10.2196/16403.

A Possible Mobile Health Solution in Orthopedics and Trauma Surgery: Development Protocol and User Evaluation of the Ankle Joint App

Florian Dittrich  1 , David Alexander Back  2 , Anna Katharina Harren  3 , Marcus Jäger  4 , Stefan Landgraeber  1 , Felix Reinecke  5 , Sascha Beck  1   6
Affiliations

A Possible Mobile Health Solution in Orthopedics and Trauma Surgery: Development Protocol and User Evaluation of the Ankle Joint App

Florian Dittrich et al. JMIR Mhealth Uhealth. .

Abstract

Background: Ankle sprains are one of the most frequent sports injuries. With respect to the high prevalence of ankle ligament injuries and patients' young age, optimizing treatment and rehabilitation is mandatory to prevent future complications such as chronic ankle instability or osteoarthritis.

Objective: In modern times, an increasing amount of smartphone usage in patient care is evident. Studies investigating mobile health (mHealth)-based rehabilitation programs after ankle sprains are rare. The aim of this study was to expose any issues present in the development process of a medical app as well as associated risks and chances.

Methods: The development process of the Ankle Joint App was defined in chronological order using a protocol. The app's quality was evaluated using the (user) German Mobile App Rating Scale (MARS-G) by voluntary foot and ankle surgeons (n=20) and voluntary athletes (n=20).

Results: A multidisciplinary development team built a hybrid app with a corresponding backend structure. The app's content provides actual medical literature, training videos, and a log function. Excellent interrater reliability (interrater reliability=0.92; 95% CI 0.86-0.96) was obtained. The mean overall score for the Ankle Joint App was 4.4 (SD 0.5). The mean subjective quality scores were 3.6 (surgeons: SD 0.7) and 3.8 (athletes: SD 0.5). Behavioral change had mean scores of 4.1 (surgeons: SD 0.7) and 4.3 (athletes: SD 0.7). The medical gain value, rated by the surgeons only, was 3.9 (SD 0.6).

Conclusions: The data obtained demonstrate that mHealth-based rehabilitation programs might be a useful tool for patient education and collection of personal data. The achieved (user) MARS-G scores support a high quality of the tested app. Medical app development with an a priori defined target group and a precisely intended purpose, in a multidisciplinary team, is highly promising. Follow-up studies are required to obtain funded evidence for the ankle joints app's effects on economical and medical aspects in comparison with established nondigital therapy paths.

Keywords: ankle sprain; mHealth; mobile phone; rehabilitation; self-care; smartphone.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: FD and SB are active in Mediploy GmbH and in the development process of the Ankle Joint App.

Figures

Figure 1
Figure 1
App screen view: (a) timeline-based aftercare plan, (b) information, and (c) training videos.
Figure 2
Figure 2
App screen view: (a) collection of patient-related data and (b) log function of patient-related data.
Figure 3
Figure 3
Mean scores of the (user) German Mobile App Rating Scale for the Ankle Joint App (surgeons: n=20 and athletes: n=20).
See this image and copyright information in PMC

References

    1. Waizy H, Harrasser N, Fehske K. [Lateral ligament injuries] Unfallchirurg. 2018 Sep;121(9):683–92. doi: 10.1007/s00113-018-0535-2.10.1007/s00113-018-0535-2 - DOI - PubMed
    1. Vuurberg G, Hoorntje A, Wink LM, van der Doelen BF, van den Bekerom MP, Dekker R, van Dijk CN, Krips R, Loogman MC, Ridderikhof ML, Smithuis FF, Stufkens SA, Verhagen EA, de Bie RA, Kerkhoffs GM. Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline. Br J Sports Med. 2018 Aug;52(15):956. doi: 10.1136/bjsports-2017-098106.bjsports-2017-098106 - DOI - PubMed
    1. Bielska IA, Wang X, Lee R, Johnson AP. The health economics of ankle and foot sprains and fractures: a systematic review of English-language published papers. Part 1: Overview and critical appraisal. Foot (Edinb) 2019 Jun;39:106–14. doi: 10.1016/j.foot.2017.04.003.S0958-2592(16)30056-6 - DOI - PubMed
    1. Hupperets MD, Verhagen EA, Heymans MW, Bosmans JE, van Tulder MW, van Mechelen W. Potential savings of a program to prevent ankle sprain recurrence: economic evaluation of a randomized controlled trial. Am J Sports Med. 2010 Nov;38(11):2194–200. doi: 10.1177/0363546510373470.0363546510373470 - DOI - PubMed
    1. Harrington KD. Degenerative arthritis of the ankle secondary to long-standing lateral ligament instability. J Bone Joint Surg Am. 1979 Apr;61(3):354–61. - PubMed

Publication types