As telerehabilitation is becoming a regular practice in healthcare, especially since the COVID-19 pandemic started, many are wondering how safe and effective it really is. At moveUP, we have been working on answering that question for years.

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In 2017-2018, we participated in our first clinical study, the MORE study, to test the effectiveness and safety of telerehabilitation. We followed 200 knee and hip surgery patients using our app and an activity tracking device and compared their results with a control group at three months post-surgery. The results of the study, which align with the latest research, showed that telerehabilitation is as safe and as effective as standard care. However, the crucial aspect that makes remote therapy safe and efficient is the continuous follow-up and communication with medical professionals.  

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Digital technology has opened new possibilities in healthcare and doctor-patient communication. Though telemedicine has been a practice for a long time, remote rehabilitation or telerehabilitation has emerged as one of the most prominent trends. Especially in the past couple of decades, many hospitals and care centers started offering remote rehab as an additional service.

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However, the COVID-19 pandemic has normalized remote consulting and rehab and forced many to adapt. Telerehabilitation is becoming a regular practice promising easier access and better patient experience, and cost reductions for hospitals.

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With such fast developments in technology, you might wonder how safe remote rehab is compared to standard care.

Well, at moveUP, we have been working hard to answer this question.

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Evaluating since the start

Back in 2017, after two years of careful development guided by the insights of experienced surgeons and physical therapists, market research, and numerous conversations with medical professionals, we set out to test remote therapy in a clinical study.

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Our first study, the MORE clinical study, was a part of the national mobile health program for e-health in Belgium. The study took place in 2017-2018 and followed 200 patients who had their knee or hip surgery during that period. The patients had their surgery in three Belgian hospitals: AZ Delta in Roeselare, AZ Maria Middelares in Ghent, and Clinique Saint-Jean in Brussels. We provided the patients with a moveUP app and an activity-tracking device to monitor their progress before and after their surgery. We also selected a control group of patients, similar in age and gender, who followed the standard post-operation rehabilitation.

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The study was a great success, and the positive results earned us a CE marking in October 2017. This indicates that our solution has been verified as safe and effective for commercial usage. Our initial clinical validation was just the beginning, and we have been consistently conducting evaluations ever since. If you're curious, you can read more about our validation journey here if you are interested.

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But let us go back to the question of the safety and efficiency of telerehabilitation. We have learned that the MORE clinical study’s results align with the literature and later confirm similar conclusions in other studies.^[1] Telerehabilitation is as effective and safe as standard rehabilitation under the condition that it is done well.

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What do we mean by that?

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More than remote consultation

Telerehabilitation is a broad field and, in its most general sense, can mean any use of the internet or telecommunications to provide physical, occupational, or speech therapy to patients in their homes. However, what makes it safe and efficient is not the technology itself but the communication and medical professionals behind it. Our experience and research show that technology is a great tool to help and support medical work rather than replace it. At moveUP, we understood this early on and built our solution around human interaction and professional help.

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The MORE clinical study was our first proof of this. The patients received more than the app and activity tracker - they gained a comprehensive information source, a tool to monitor their progress daily, exercise instructions, and an asynchronous HIPAA-compliant communication platform. Most importantly, they were given the opportunity to provide daily feedback and connect with our medical team at any time.  

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Our team of professional physiotherapists played a crucial role here. They monitored the patients daily and gave them personalized advice and exercises adapted to their needs and levels of activity. The medical team looked at the number of daily steps, patients’ reports on pain and joint stiffness, as well as the objectives and individual situation of each patient. They used all of this information to give personalized therapy and were available to answer concerns and questions. The team could also get a specialist involved in the care when needed.

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Comparing the two types of rehabilitation

We thoroughly studied the results of telerehabilitation on 200 patients as previously explained. We then compared their outcomes to those of the control group three months after the operation to see if there were any differences from standard rehabilitation.

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We specifically focused on safety, efficiency, and satisfaction.

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Safety

Throughout the study period, there were three instances of readmission. One was due to anxiety on the 10th day, another was related to an injection on the 9th day, and the third was for manipulation under anesthesia.

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A study that we did in 2021 to evaluate the safety of remote rehab after a reduced length of stay in a Belgian hospital brought us a similar conclusion. You can read about that particular study here. In both cases, remote rehabilitation using the moveUP system and approach was as safe as regular rehabilitation.

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Efficacy

Usually, we consider rehabilitation complete when the patient is free of pain, is no longer taking pain medication, has recovered their function, and returned to the pre-operative level of physical activity. In the MORE study, the average duration of rehabilitation with moveUP was 77 days. We recorded the efficiency of the therapy using the patient’s reported outcomes duration of the use of anti-inflammatory drugs and crutches.

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On average, patients using moveUP stopped taking painkillers on the 17th day and stopped using crutches on the 34th day after the operation.

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The pain and daily activities scores were significantly higher for the telerehabilitation group than the control group. There were no significant differences between the groups for symptoms and quality of life.

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Satisfaction

The two groups of patients did not differ significantly regarding satisfaction at three months post-surgery. However, those that used moveUP were happy with the app and rated the ease of use at 81%. We focused more on understanding our app users and improving their experience after finishing this study. In the years since, we have been glad to reach high satisfaction levels with our patient app.

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Telerehabilitation as a viable option for knee and hip patients

Overall, we saw similar results for the telerehabilitation and control groups when we compared the three months after the operation. Thanks to this, we had our first proof that rehabilitation with moveUP is safe and effective. The results also align with some of the latest research, all showing us that remote therapy is as safe and as effective as standard care when done well.

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Want to know more? You can access the full MORE study here.

If you have any questions about this or any other studies we did, get in touch with our team. Or better yet, why not try our moveUP app for yourself and experience the difference that telerehabilitation can make in your life?

^[1]

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^{(No date) Library Cochrane - Cochrane Library. Available at: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013040.pub2/pdf/CDSR/CD013040/CD013040_abstract.pdf (Accessed: 29 June 2023).}

^{Cottrell MA;Galea OA;O’Leary SP;Hill AJ;Russell TG; (no date) Real-time telerehabilitation for the treatment of musculoskeletal conditions is effective and comparable to standard practice: A systematic review and meta-analysis, Clinical rehabilitation. Available at: https://pubmed.ncbi.nlm.nih.gov/27141087/ (Accessed: 29 June 2023).}

^{Dario AB;Moreti Cabral A;Almeida L;Ferreira ML;Refshauge K;Simic M;Pappas E;Ferreira PH; (no date) Effectiveness of telehealth-based interventions in the management of non-specific low back pain: A systematic review with meta-analysis, The spine journal : official journal of the North American Spine Society. Available at: https://pubmed.ncbi.nlm.nih.gov/28412562/ (Accessed: 29 June 2023).}