Empowering Recovery: Patient-reported Outcomes of a New Hybrid Telerehabilitation Platform for Post-tsa and RCR Therapy

Research Objectives: To investigate the effectiveness and outcomes associated with a telerehabilitation platform for anatomic total shoulder arthroplasty (TSA), reverse total shoulder arthroplasty (rTSA), and rotator cuff repair (RCR). Compliance with PT visits and home exercises are often poor with 70% of patients discontinuing therapy by six weeks[1]. BandConnect, a hybrid-telerehabilitation platform, allows PTs to recreate the in-clinic experience at home using sensor-enabled handles and resistance bands. This study assessed BandConnect's effectiveness in increasing compliance, function, and improving patient-reported outcomes (PROs).

Design: Patients >18-years old undergoing TSA, rTSA, or RCR by fellowship-trained surgeons were recruited into a single-arm prospective study. Patients received PT from one of six PTs. PTs prescribed home exercise programs via the BandConnect website and patients used the mobile app to complete their prescribed exercise regimen with instructions. Outcome measures were collected at baseline, 3-months, and 6-months. A mixed effects model for repeated measures data, with an adjusted alpha level of p< 0.017 was employed.

Setting: The study was conducted across five outpatient PT clinics.

Participants: Of 79 patients recruited via convenience sampling, 37 completed rehabilitation; 21 underwent RCR, 8 RTSA, and 8 TSA. The average age was 67.1±10.9 years, with an average BMI of 31.8±7.9 kg/m². Patients demonstrated an average compliance of 70.2%±21.3% and reported an average satisfaction rating of 9.3±1.4.

Interventions: Following surgery, patients received the BandConnect platform at their initial evaluation. By utilizing motion sensors, the app delivered real-time biofeedback, offering personalized guidance on exercise form based on prior visits. The system provides patients cues regarding movement velocity, dynamic visual instructions, and tracks metrics during exercise. The PTs could adjust treatment as necessary during the plan of care.

Main Outcome Measures: Primary outcomes measures included range of motion(ROM), PROs, compliance with PT, satisfaction, and total missed appointments.

Results: The RCR subgroup showed significant improvements in ASES, VAS, SST, and QuickDASH at 3-months (p < 0.001, p< 0.01, p< 0.001, p< 0.001, respectively) and 6-months (p < 0.001, p< 0.001, p< 0.01, p< 0.001, respectively) compared to baseline. SANE improved at 6-months compared to baseline(p < 0.01), with further ASES (p < 0.01) and SST (p < 0.001) improvements between 3 and 6-months.

In the RTSA/TSA subgroup, ASES, VAS, SANE, SST, and QuickDASH significantly improved at 3-months (p < 0.001 for all) and 6-months (p < 0.001 for all) compared to baseline.

Conclusions: This study highlights BandConnect’s potential to improve outcomes following shoulder surgery. Patients achieved high compliance and reported high satisfaction.

Author(s) Disclosures: McInturf, Nayak, and Hasan have a financial interest in Band Connect.