Telerehabilitation for Anterior Cruciate Ligament Reconstruction - TAR Program in Adolescents

KK Women's and Children's Hospital

Status: Enrolling

Conditions: Anterior Cruciate Ligament Injuries; Telerehabilitation; Anterior Cruciate Ligament

Treatments: Other: Standard rehabilitation sessions; Device: Telerehabilitation TAR program using a mobile application

Study type: Interventional

Funder types: Other

Identifiers

NCT05799235

2022/2379

Details and patient eligibility

About

Anterior cruciate ligament (ACL) injuries are common in adolescents and its prevalence has increased over the years, especially with more adolescents engaging in physical activities and competitive sports. Standard of care for these injuries would be an ACL reconstruction (ACLR) to allow return to function and sports and reduce the risk of post-traumatic arthritis and recurrent knee injuries. Rehabilitation post-ACLR is crucial to optimise surgical outcomes and prevent re-rupture of ACL. However, good compliance to rehabilitation is often a challenge for patients and healthcare providers.

Telerehabilitation for this group of patients may help to augment rehabilitation by improving patient compliance and overcome barriers to behavioural change often observed in traditional in-person physiotherapy. It can also allow remote monitoring and provide feedback to patients during exercises. In addition, it is a useful tool during pandemic when in-person visits are not possible. Currently, very few studies have evaluated the use of telerehabilitation with remote monitoring for ACLR, especially in adolescents. The use of home-based telerehabilitation post ACLR may be key to improving patient motivation and exercise compliance in adolescents.

For this pilot study, the intervention group will undergo the TAR program in addition to standard care, which involves self-administered exercises in initial 12 weeks post ACLR using a mobile application. The mobile application will detect key landmarks on the body for human pose estimation. Participants will be able to perform their exercises with real-time feedback given, allowing for proper execution of the exercises. Exercise adherence, range of motion and pain scores will be tracked via the application and therapists are able to monitor via the online dashboard. The control group will undergo standard in-person physiotherapy.

Primary aim of this study is to examine exercise adherence in TAR program versus standard care post ACLR in adolescents. Secondary aims of this study are to examine the effects of TAR program on knee strength, range, function, quality of life, treatment satisfaction, self-determination and number of face-to-face rehabilitation sessions required after ACLR.

Enrollment: 40 estimated patients

Sex: All

Ages: 12 to 20 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Participants age 12 to 20 years old
• Participants undergoing ACLR surgery
• Participants willing to be included in either the intervention group (utilizing the mobile application) or control group

Exclusion criteria

• Participants with complications after ACLR surgery
• Participants with significant neurological or other lower limb impairments or conditions affecting mobility and function
• Participants with previous ACL surgeries of the same affected lower limb
• Participants with previous surgeries or trauma to the unaffected lower limb

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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40 participants in 2 patient groups

Telerehabilitation TAR program using a mobile application (intervention group)

Experimental group

Description:

Participants in the intervention group will undergo the telerehabilitation TAR program and install and utilise the application on their mobile device, and self-administer the home exercises as prescribed by their physiotherapists. The mobile application uses novel deep learning algorithm on a mobile platform to detect key landmarks on the body for human pose estimation. Participants will be able to perform their rehabilitation exercise with real-time feedback allowing for proper execution of the exercises. The participants will be instructed on the installation and use of the mobile application and will be expected to perform the prescribed exercises independently (using the application) as instructed by their Physiotherapists. This application will be used for the initial 12 weeks of post-op rehabilitation.

Treatment:

Device: Telerehabilitation TAR program using a mobile application

Standard rehabilitation (control group)

Active Comparator group

Description:

Participants in the control group will attend standard in person rehabilitation sessions at the outpatient clinic. Participants will be prescribed a home exercise program as per standard care.

Treatment:

Other: Standard rehabilitation sessions