None listed
Conditions
Brief summary
The primary aim of this trial is to compare the effectiveness of face-to-face physiotherapy with a supported home exercise program delivered through an App. The trial will determine whether a 6-week supported home exercise programme provides outcomes as good or better than (i.e., not inferior to) an equivalent period of face-to-face physiotherapy for the treatment of a wide range of musculoskeletal conditions. This model of care could provide an accessible and cost-effective way of managing musculoskeletal conditions that is particularly relevant in Australia where the population is geographically disbursed and access to physiotherapy healthcare limited.
Interventions
A single-blind randomised controlled pragmatic non-inferiority trial will be undertaken to compare a course of physiotherapy as typically provided in Sydney government hospitals with a supported home exercise program administered through an App and supplemented with text messages and two telephone calls. Cost-effectiveness will be evaluated from a health funder and patient perspective.
Participants allocated to the Supported Home Exercise Group will initially receive one face-to-face session wi
A single-blind randomised controlled pragmatic non-inferiority trial will be undertaken to compare a course of physiotherapy as typically provided in Sydney government hospitals with a supported home exercise program administered through an App and supplemented with text messages and two telephone calls. Cost-effectiveness will be evaluated from a health funder and patient perspective. Participants allocated to the Supported Home Exercise Group will initially receive one face-to-face session with the trial physiotherapist (study coordinator), lasting 30 to 60 minutes. They will then be managed remotely for the next 6 weeks. During the initial session the trial physiotherapist (study coordinator) will prescribe an individualised 6-week home exercise program consisting of a battery of 5 to 10 exercises. This will be delivered to patients’ mobile devices using an App (www.physiotherapyexercises.com). The number of repetitions and sets will be determined by the trial physiotherapist (study coordinator). Participants will be asked to complete their exercises at least once every day for the intervention period of 6 weeks. Participants will record exercise adherence on their App. These data will be automatically transferred to a password protection section of the website which will be accessed by the trial physiotherapist (study coordinator) to remotely monitor exercise adherence. The trial physiotherapist (study coordinator) will provide ongoing support through weekly text messages. The purpose of these text messages will be to encourage adherence to the prescribed exercises and provide the participants with encouragement. The participants will also receive a telephone call from the trial physiotherapist (study coordinator) at 2 and 4 weeks to ensure adherence and provide feedback, support and advice. Participants will be rung more frequently if their exercise adherence is poor. There will be the option to provide an additional face-to-face physiotherapy session if a participant deteriorates or the trial physiotherapist (study coordinators) is concerned about the participant’s safety or well being for any reason.
Sponsors
Northern Sydney Local Health District
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
A person will be eligible to participate if he or she: • is 18 years or over and able to provide informed consent in writing • has a musculoskeletal condition. Examples include: back pain, hip or knee osteoarthritis, whiplash-associated disorders, ankle sprains, post fracture, sporting injury and post hip or knee replacement • is seeking physiotherapy treatment at the participating hospital • can speak and can read English enough to give informed consent • is able to participate for 6 weeks and will be available for 6 and 26 week follow up assessments • has access to a smart phone with internet connection • is identified by the hospital physiotherapist or trial physiotherapists (study coordinator) to have a condition appropriate for treatment with exercise, support and advice.
Exclusion criteria
A person will be excluded if he or she:: • is pregnant • has a mental illness which may affect compliance to treatment • is at risk of falling while performing the home exercises • is at clinical risk without face to face physiotherapy • is on a post-operative exercise regime prescribed by a surgeon • is deemed at risk of harm without face to face physiotherapy
Outcome results
None listed