Total knee arthroplasty and mHealth: the development of an evidence-based app wireframe to support patient rehabilitation post-TKA .

Total knee arthroplasty (TKA) is a highly successful orthopaedic surgery; however, full functional recovery can take up to a year. The incidence of TKA has doubled in Scotland since 2001, reflecting a dramatic global rise. mHealth, the delivery of health care via mobile phone technology, has been used for a wide range of conditions. Although numerous mHealth interventions exist for TKA rehabilitation, rapid development of mobile apps often outpaces rigorous research, potentially compromising intervention quality and effectiveness. This doctoral study aimed to develop a novel mobile phone app to support individuals recovering from TKA. This was achieved by integrating evidence and theory-based interventions with lived-experience, using a stakeholder-led process to produce a novel mHealth intervention tailored for TKA rehabilitation. A scoping review of peer-reviewed and grey literature was conducted to map the global landscape on mHealth rehabilitation interventions following lower limb joint replacement, prior to stakeholder involvement. The review identified existing interventions, outcome measures, app features, and the extent of stakeholders' participation in app development. These findings informed app development, which combined the principles of co-production with the first four steps of Intervention Mapping. This systematic, stakeholder-guided approach ensured the resulting intervention reflected user combined needs and experiences. Three iterative rounds of data collection with TKA patients and experienced physiotherapists engaged participants in needs assessment and qualitative design to refine app content. The review identified 68 articles examining the intersection of joint replacement and mHealth in the literature, of which roughly 40% (28 articles) were primary research (pilot, feasibility, protocols), demonstrating the growth of this area of study. Only three included stakeholder input in their app development, and none fully engaged stakeholders throughout. There was substantial heterogeneity in outcome measures used in lower limb joint replacement rehabilitation apps, with few studies evaluating long-term impact on TKA outcomes or satisfaction. This study integrated Intervention Mapping and co-production to develop the wireframe for a mHealth rehabilitation app. Iterative development reconciled participant perspectives, with the final version supporting self-management through a combination of novel app features and components identified in the scoping review. The three key components of the app included rehabilitation and progress tracking, education, and accessible support through signposting. Novel features include tailored exercise plans, progress tracking, and diverse educational resources to support various learning needs and preferences. This thesis establishes a foundation for the development of a fully functional mHealth app to support TKA rehabilitation by creating evidence-based features and interventions. The next research priorities are to develop app prototype and to conduct a feasibility study evaluating its acceptability.

Grantor dc:publisher.institution

Robert Gordon University

Year dc:date.issued

2025

Author dc:creator

• Chidester, Matthew Austin

Advisor dc:contributor.advisor

• J. Shim

• Total knee arthroplasty (TKA)
• mHealth rehabilitation
• Co-production
• Stakeholder-led development
• Intervention mapping
• Postoperative recovery
• Mobile health app development

Language dc:language

en

Identifier

oai:rgu-repository.worktribe.com:3217111
https://doi.org/10.48526/rgu-wt-3217111

OAI identifier oai:identifier

oai:rgu-repository.worktribe.com:3217111