Title : Online Community of Knee-patients Requiring Arthroplasty .
Dr Philip Bright
Introduction : There is suggestion that use of home-based exercise and patient-engagement with kneespecific online support tools may be suitable to help with knee pain sufferers . This proposed Research for Patient Benefit study aims to see if it is possible for patients to report their progress and experiences via an online forum when engaging with a series of home-based knee exercises using bathroom scales . This is with a view to help patients improve their adoption of prehabilitation activities prior to total knee replacement surgery .
Methods : Using a feasibility design , knee replacement candidates would be recruited to undergo standard care complemented with bathroom scale-facilitated , home exercises and report their progress . Reporting would be undertaken using an online forum specifically created for the study . The self-reported outcomes would then be compared to measures taken from patients following standard care alone . Statistical comparison between the groups , using a recognised knee outcome measure , would be expected and thematic analysis of narrative commentary from the patients would be undertaken . Visual representation of individual patient data in the form of graphs would be undertaken for determining statistical significance in progress for each participant .
Results : Patient and public involvement are underway to inform study development . Results would include reporting of patient experience in engaging with prehabilitation exercises , derived from posts added to an online Padlet forum ( see Figure1 ). Statistical significance for single subjects would be explored using a statistical process control . The WOMAC outcome measure would be compared between the two study groups . The analytical strategy has been reported as feasible in previous studies .
Conclusion : Patients can potentially engage with an online forum for reporting progress when undertaking exercise programs . The importance of individualized visual data to patients and the role of forums in monitoring patients ’ progress in symptomatic knee pain populations need further consideration .
Impact : Patient self-monitoring and follow-up is lacking due to high demand on out-patient services in the NHS and potential over-reliance on complex approaches . The scope to extend physical therapy support for reporting , monitoring and compliance to a domiciliary setting is warranted , particularly with regard to a costeffective and accessible solution .