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App-based supplemental exercise in rehabilitation, adherence, and effect on outcomes: a randomized controlled trial [with consumer summary]
Li I, Bui T, Phan HT, Llado A, King C, Scrivener K
Clinical Rehabilitation 2020 Aug;34(8):1083-1093
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

QUESTION: To determine the uptake of an app-based supplemental exercise programme in a rehabilitation setting and the effect of such a programme on length of stay and function compared to usual care physiotherapy. DESIGN: Randomized controlled trial with random allocation and assessor blinding. PARTICIPANTS: A total of 144 individuals with mixed diagnoses (orthopaedic, neurological, reconditioning) admitted for inpatient sub-acute rehabilitation. INTERVENTIONS: Participants were randomly allocated to usual care physiotherapy (control group) or usual care physiotherapy with the addition of an app-based supplemental exercise programme (intervention group). OUTCOME MEASURES: The primary measure of interest was total supplementary exercise dosage completed by the intervention group. The primary between-group outcome measure was length of stay with secondary measures including walking endurance (Six-Minute Walk Test), walking speed (10-Metre Walk Test), functional mobility (Timed Up and Go Test) and level of disability (Functional Independence Measure). RESULTS: Participants in the intervention group performed 7 minutes (SD 9) or 49 repetitions (SD 48) of supplementary exercise using the app each day. There were no differences between the groups for length of stay (mean difference (MD) -0.5 days, 95% confidence interval (CI) -3.2 to 2.2) or change in any secondary functional outcome measures, including walking speed (MD -0.1 m/s, 95% CI -0.2 to 0.0) and disability (MD -0.9, 95% CI -3.6 to 1.8). CONCLUSION: A small supplementary exercise dose was achieved by participants in the intervention group. However, such a programme did not affect length of stay or functional outcomes when compared to usual care.

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