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. 2023 Mar 23;24(1):221.
doi: 10.1186/s12891-023-06255-7.

Smartphone-assisted training with education for patients with hip and/or knee osteoarthritis (SmArt-E): study protocol for a multicentre pragmatic randomized controlled trial

Franziska Weber  1   2 , Carsten Müller  3 , Carolin Bahns  4 , Christian Kopkow  4 , Francesca Färber  5 , Paul Gellert  5 , Ina Otte  6 , Horst Christian Vollmar  6 , Werner Brannath  7 , Freya Diederich  8 , Stephan Kloep  7 , Heinz Rothgang  8 , Valerie Dieter  9 , Inga Krauß  9 , Corelien Kloek  10 , Cindy Veenhof  11   10 , Sandra Collisi  12 , Ute Repschläger  12 , Hannes Böbinger  13 , Christian Grüneberg  3 , Christian Thiel  3 , Dirk Peschke  3
Affiliations

Smartphone-assisted training with education for patients with hip and/or knee osteoarthritis (SmArt-E): study protocol for a multicentre pragmatic randomized controlled trial

Franziska Weber et al. BMC Musculoskelet Disord. .

Abstract

Introduction: Hip and knee osteoarthritis are associated with functional limitations, pain and restrictions in quality of life and the ability to work. Furthermore, with growing prevalence, osteoarthritis is increasingly causing (in)direct costs. Guidelines recommend exercise therapy and education as primary treatment strategies. Available options for treatment based on physical activity promotion and lifestyle change are often insufficiently provided and used. In addition, the quality of current exercise programmes often does not meet the changing care needs of older people with comorbidities and exercise adherence is a challenge beyond personal physiotherapy. The main objective of this study is to investigate the short- and long-term (cost-)effectiveness of the SmArt-E programme in people with hip and/or knee osteoarthritis in terms of pain and physical functioning compared to usual care.

Methods: This study is designed as a multicentre randomized controlled trial with a target sample size of 330 patients. The intervention is based on the e-Exercise intervention from the Netherlands, consists of a training and education programme and is conducted as a blended care intervention over 12 months. We use an app to support independent training and the development of self-management skills. The primary and secondary hypotheses are that participants in the SmArt-E intervention will have less pain (numerical rating scale) and better physical functioning (Hip Disability and Osteoarthritis Outcome Score, Knee Injury and Osteoarthritis Outcome Score) compared to participants in the usual care group after 12 and 3 months. Other secondary outcomes are based on domains of the Osteoarthritis Research Society International (OARSI). The study will be accompanied by a process evaluation.

Discussion: After a positive evaluation, SmArt-E can be offered in usual care, flexibly addressing different care situations. The desired sustainability and the support of the participants' behavioural change are initiated via the app through audio-visual contact with their physiotherapists. Furthermore, the app supports the repetition and consolidation of learned training and educational content. For people with osteoarthritis, the new form of care with proven effectiveness can lead to a reduction in underuse and misuse of care as well as contribute to a reduction in (in)direct costs.

Trial registration: German Clinical Trials Register, DRKS00028477. Registered on August 10, 2022.

Keywords: Combined modality therapy; Education; Exercise therapy; Osteoarthritis; Physical therapy modalities; Telerehabilitation.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow of the SmArt-E intervention programme
Fig. 2
Fig. 2
Screenshot of the SmArt-E app showing the exercise feature
Fig. 3
Fig. 3
Screenshot of the SmArt-E app showing the today view
Fig. 4
Fig. 4
Patient flow of the SmArt-E study
Fig. 5
Fig. 5
Flow-Chart of the recruitment, screening, assessment and randomization process
See this image and copyright information in PMC

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