The effectiveness of using an exercise App to improve adherence to home exercise programs prescribed by physiotherapists: a randomised controlled trial.

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The primary purpose of our study is to determine whether home exercise programs delivered via an App have greater adherence rates than usual methods of prescription used by physiotherapists. We will conduct an assessor- blinded, randomised controlled trial, with a sample size of 80. Subjects will be deemed eligible for inclusion if they meet the following criteria: * have sustained an upper or lower limb fracture, injury or other musculoskeletal condition * have been prescribed a set of exercises for the next 4 weeks (or longer) by their treating physiotherapist * have been advised to complete their exercises at least 3 times per week * have access to a smart phone, tablet device or computer * are over 18 years of age and are able to provide informed consent * are willing to participate in the trial * are not expected to require surgery or be readmitted to hospital during the trial Subjects will be excluded if they: * are unlikely or unwilling to co-operate (e.g. serious medical condition, cognitive impairment, drug dependency, psychiatric illness, behavioural problems) * are scheduled to receive face- to- face physiotherapy for their condition or injury within the next 4 weeks * have limited English This trial will be undertaken in patients who have been prescribed a home exercise program by physiotherapists based on the orthopaedic ward or short stay surgical unit of Royal North Shore Hospital (RNSH); or from the outpatient department or hand therapy clinic of Royal North Shore Hospital (RNSH). Participants will be randomised to receive their home exercise program delivered via either the current paper-based method alone, or via our App with supplementary follow-up phone calls. The primary outcome will be self-rated exercise adherence in the first 4 weeks following prescription of exercises by a physiotherapist. The secondary outcomes will include functional status, degree of disability, perceptions of treatment effectiveness, satisfaction with healthcare service delivery and assessor-rated exercise adherence. Baseline assessments will be conducted just prior to randomisation by treating physiotherapists. Follow up assessments will be conducted 4 weeks after randomisation by a blinded assessor via telephone interview and online survey.