Activate TKR – mobile phone application

The Australian e-Health Research Centre at CSIRO, together with Johnson & Johnson Medical Devices Australia, have designed and developed Activate TKR, an orthopaedic support technology platform, which comprises a mobile phone application (app), a wearable activity tracker, and a clinical web portal.

The Challenge: Patients aren’t completing rehab following total knee replacements

The app aims to assist patients in managing their surgery preparation, speed up recovery and to bridge the communication gaps between clinicians and patients.

There was a 77 per cent increase in TKR surgeries from 2003 to 2014 in Australia, and this trend is likely to continue due to factors such as the aging population and increased obesity rates.

Studies have shown that rehabilitation exercises following TKR surgery can lead to faster recovery times, however many patients fail to implement an effective preparation or rehabilitation plan.

The Response: A digital platform to help patients manage their rehab

We have developed and are trialing a digital support platform to cater for increased patient engagement with TKR rehabilitation services (surgical preparation and recovery). As part of the platform (web portal), clinicians can configure individual physiotherapy programs and monitor patient progress remotely.

In addition the app provides flexibility in TKR care delivery, particularly in rural remote areas, or for patients with busy lifestyles and has potential to achieve the same clinical outcomes as normal ‘business as usual’ care.

The Results: RCT Trials launched in 2016

An RCT was launched in November 2016 and currently ongoing trial with four hospitals in NSW and QLD, targeting 150 patients undergoing TKR surgery. The information captured on the digital tool includes information on the surgery and preparation, patient coaching, assistance with physiotherapy, plus use of wearables to motivate patients to self monitor and engage. The study will show how the technology impacted patients and carers.

Outputs expected in 2018/ 2019

  • Preliminary trial data analysis (clinical efficacy, patient/ care satisfaction, economics) outputs expected in 2018/ 2019
  • Qualitative research findings

Our new TKR rehab app aims to assist patients manage their surgery preparation and speed up recovery.

Total Knee Replacement App

Show transcript

Dr Michael Hunter: Good morning Phillip. How are you? Welcome. Have a seat.

[Image changes to show Phillip’s face and then the image changes to show Dr Michael Hunter talking to the camera]

Phillip you’re now six weeks after your knee replacement and you’re going very well.

[Image changes to show a view of the portal on the computer screen]

Through the portal we have in the office I’ve been able to track your progress

[Image changes to show Phillip listening]

which has been fantastic.

[Image changes to show Dr Michael Hunter talking to the camera and then the image changes to show Phillip listening]

I can see that your pain and the physiotherapy’s going well. The exercise you’re doing well

[Image changes to show a graph displaying Phillip’s steps on the portal]

but I notice your steps are slightly reduced recently

[Image shows a finger pointing at the graph on the portal and then the image changes to show a side view of Dr Michael Hunter talking]

and there’s one day here in particular note that you’re down to about 1,000 steps.

[Image changes to show Phillip listening and then talking to the camera]

Can you remember what was happening that day?

Phillip: Well, the weather hasn’t permitted it (laughs).

[Image changes to show Dr Michael Hunter talking to the camera]

Dr Michael Hunter: The weather has been pretty lousy recently so, I’ll give you that and portal also mentions you’re a bit stiff.

[Image changes to show a range of motion graph on the portal]

Your range of movement’s reduced. How are you going with that?

[Image changes to show Phillip talking to the camera]

Phillip: I’m doing them every day. It’s just pushing through the initial pain

[Image changes to show Dr Michael Hunter listening]

with the exercises and stretching.

[Image changes to show data on the portal and then the camera zooms in on dots on the portal displaying pain, rom, steps and physio]

Dr Michael Hunter: Right OK. The green dots here on the screen show that you’re doing very well in a couple of areas

[Image changes to show Phillip listening]

but there are a couple of red dots here that are highlighted that I’ve been keeping an eye on

[Image changes to show Dr Michael Hunter talking to the camera]

that document that your range of motion’s just slightly decreased and obviously after a knee replacement

[Image changes to show a range of motion bar graph on the portal]

we’re very keen for that to be worked on, to be pushed, to try and increase that range of motion.

[Image changes to show Phillip listening]

I can keep an eye on you every day

[Image changes to show a hand pointing at data on the portal and then the data scrolls through on the portal]

and observe that and observe your response to the physiotherapy.

[Image changes to show Phillip listening]

I understand now you’ve got an appointment with your physiotherapist.

[Image changes to show data scrolling through on the portal]

He’s going to take you through the next six weeks of your physio and rehab programme

[Image changes to show Dr Michael Hunter talking to the camera]

while I keep an eye on you on the portal.

[Image changes to show a rear view of Phillip and Jamie Exton entering the room]

Jamie Exton: Well, hi Phil.

[Image changes to show a view of Jamie Exton talking to the camera and text appears: Jamie Exton, Physiotherapist]

You’re halfway through your treatment and I hear you’ve just been to see Dr Hunter. How did that go?

[Image changes to show Phillip and Jamie Exton talking together]

He was happy with everything?

Phillip: Yeah.

[Image changes to show Jamie Exton talking to the camera]

Jamie Exton: OK. Well, obviously you know you’re part of a trial into using this app and the portal that we’ve developed with total knee joint replacements.

[Image changes to show a back view of Jamie Exton talking while Phillip listens]

So, over the next six weeks you’re going to notice that every week

[Image changes to show a view of a finger scrolling through information on a Smartphone]

we’re going to be updating your exercises and we’ll be using the portal for that. As far as the app goes you’ve probably noticed already that there’s a lot of education material in there. Have you been using that educational material?

[Image changes to show Jamie Exton talking to the camera]

I mean the purpose of that is it follows you as you journey through having a knee joint replacement before and after your surgery.

[Image changes to show a view of a finger scrolling through information on a Smartphone]

So, you’ll notice that when you get to the four-week mark, you’ll notice that the education material changes and it really talks about nutrition and it talks about

[Image changes to show Jamie Exton talking to the camera]

some of the other benefits of exercise and wellbeing.

[Image changes to show the Smartphone being turned sideways and data being displayed]

If you actually turn the phone sideways, you’ll see that you can actually see your last week’s data. So, you can actually see how you’re going with your steps. Have you ever tried that?

Phillip: Yeah.

[Image changes to show Jamie Exton talking to the camera]

Jamie Exton: It’s a really good feature. We’re going to be changing a few of your exercises now and

[Image changes to show a view of a finger scrolling through information on a Smartphone and then the Smartphone being turned sideways and displaying an exercise]

we’re going to be trying to really press on and improve your physical function over the next little while. Today we’re going to focus a lot more on the straightening exercises and

[Image changes to show Jamie Exton talking to the camera]

I’m going to use the app to help us with that.

[Image changes to show Phillip listening and Jamie Exton talking]

Phillip: OK.

[Image changes to show Phillip’s feet on a stool and then the camera zooms up to show Phillip’s outstretched leg]

Jamie Exton: I want you to lean forward and try and straighten the back of your knee. Feel a stretch through here through the back of this hamstring. This is a variation of the stretch that we just showed you. You’re one of many people on this trial.

[Image changes to show Jamie Exton talking to the camera]

The CSIRO developed this trial.

[Image changes to show Phillip listening and Jamie Exton talking]

We’re going to be really trying to improve this software over the next little while.

[Image shows a back view of Phillip walking along the front of a building] [CSIRO logo and text appears: Australia’s innovation catalyst]