Development of the intelligent knee osteoarthritis lifestyle app: A person-based approach

Stevenson, Richard D. M.; Chowdhury, Enhad A.; Inza, Victor B.; Western, Max J.; Walsh, Nicola E.; Jones, Simon L.; Bilzon, James L. J.

Abstract

Background: Knee osteoarthritis is one of the most prevalent long term health conditions globally. Exercise and physical activity are now widely recognised to significantly reduce joint pain, improve physical function and quality of life in patients with knee osteoarthritis. However, prescribed exercise without regular contact with a healthcare professional often results in lower adherence and poorer health outcomes. Digital mobile health (mHealth) technologies offer great potential to support people with long-term conditions such as knee osteoarthritis more efficiently and effectively and with relatively lower cost than existing interventions. However, there are currently very few mHealth interventions for the self-management of knee osteoarthritis. The aim of the present study was to describe the development process of a mHealth app to extend the support for physical activity and musculoskeletal health beyond short-term, structured rehabilitation through self-management, personalised physical activity, education, and social support. Methods: The development of the intelligent knee osteoarthritis lifestyle application intervention involved an iterative and interconnected process comprising intervention ‘planning’ and ‘optimisation’ informed by the person-based approach framework for the development of digital health interventions. The planning phase involved a literature review and collection of qualitative data obtained from focus groups with individuals with knee osteoarthritis (n = 26) and interviews with relevant physiotherapists (n = 5) to generate ‘guiding principles’ for the intervention. The optimisation phase involved usability testing (n = 7) and qualitative ‘think aloud’ sessions (n = 6) with potential beneficiaries to refine the development of the intervention. Results: Key themes that emerged from the qualitative data included the need for educational material, modifying activities to suit individual abilities and preferences as well as the inclusion of key features such as rehabilitation exercises. Following a user-trial further changes were made to improve the usability of the application. Conclusions: Using a systematic person-based, development approach, we have developed the intelligent knee osteoarthritis lifestyle application to help people maintain physical activity behaviour. The app extends the support for physical activity and musculoskeletal health beyond short-term, structured rehabilitation through personalised physical activity guidance, education, and social support.

• Journal Article Type: Article
• Acceptance Date: Feb 26, 2024
• Online Publication Date: Mar 2, 2024
• Publication Date: Mar 2, 2024
• Deposit Date: Mar 12, 2024
• Publicly Available Date: Mar 13, 2024
• Journal: BMC Musculoskeletal Disorders
• Print ISSN: 1471-2474
• Publisher: BioMed Central
• Peer Reviewed: Peer Reviewed
• Volume: 25
• Issue: 1
• Article Number: 189
• DOI: https://doi.org/10.1186/s12891-024-07313-4
• Keywords: Self-management, Digital health, Humans, Mobile Applications, Osteoarthritis, Knee - rehabilitation, Life Style, Knee osteoarthritis, Quality of Life, Physical activity, Self-Management - methods, Mobile application
• Public URL: https://uwe-repository.worktribe.com/output/11794413
• Additional Information: Received: 3 November 2023; Accepted: 26 February 2024; First Online: 2 March 2024; : ; : Ethical approval for the study was provided by the Department for Health Research Ethics Approval Committee for Health (REACH) at the University of Bath (Ref: EP 18/19 080). Participants were recruited through the University of the Third Age (ExternalRef removed) as well as through social media advertising. All participants provided written informed consent to participate in the study.The study was conducted in accordance with the Declaration of Helsinki and all analyses were performed in accordance with the relevant guidelines and regulations.; : Not applicable.; : The authors declare no competing interests.