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      Patients Using an Online Forum for Reporting Progress When Engaging With a Six-Week Exercise Program for Knee Conditioning: Feasibility Study

      research-article
      , BSc (Hons), PGCRM, PGCHE, PhD 1 , 2 , , , BSc (Physiotherapy), PhD 3
      (Reviewer), (Reviewer), (Reviewer)
      JMIR Rehabilitation and Assistive Technologies
      JMIR Publications
      eHealth; social media; exercise therapy; rehabilitation

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          Abstract

          Background

          The use of electronic health (eHealth) and Web-based resources for patients with knee pain is expanding. Padlet is an online noticeboard that can facilitate patient interaction by posting virtual “sticky notes.”

          Objective

          The primary aim of this study was to determine feasibility of patients in a 6-week knee exercise program using Padlet as an online forum for self-reporting on outcome progression.

          Methods

          Undergraduate manual therapy students were recruited as part of a 6-week study into knee conditioning. Participants were encouraged to post maximum effort readings from quadriceps and gluteal home exercises captured from standard bathroom scales on a bespoke Padlet. Experience and progression reporting were encouraged. Posted data were analyzed for association between engagement, entry frequency, and participant characteristics. Individual data facilitated single-subject, multiple-baseline analysis using statistical process control. Experiential narrative was analyzed thematically.

          Results

          Nineteen participants were recruited (47%, 9/19 female); ages ranged from 19 to 53 years. Twelve individuals (63%) opted to engage with the forum (range 4-40 entries), with five (42%) reporting across all 6 weeks. Gender did not influence reporting (odds ratio [OR] 0.76, 95% CI 0.06-6.93). No significant difference manifested between body mass index and engagement P=.46); age and entry frequency did not correlate (R 2=.054, 95% CI –0.42 to 0.51, P=.83). Statistically significant conditioning profiles arose in single participants. Themes of pain, mitigation, and response were inducted from the experiences posted.

          Conclusions

          Patients will engage with an online forum for reporting progress when undertaking exercise programs. In contrast to related literature, no significant association was found with reporting and gender, age, or body mass index. Individual posted data allowed multiple-baseline analysis and experiential induction from participants. Conditioning responses were evident on visual inspection. The importance of individualized visual data to patients and the role of forums in monitoring patients’ progress in symptomatic knee pain populations need further consideration.

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          Most cited references53

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          Relationships among smartphone addiction, stress, academic performance, and satisfaction with life

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            The Rise of Consumer Health Wearables: Promises and Barriers

            Lukasz Piwek and colleagues consider whether wearable technology can become a valuable asset for health care.
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              Understanding factors affecting patient and public engagement and recruitment to digital health interventions: a systematic review of qualitative studies

              Background Numerous types of digital health interventions (DHIs) are available to patients and the public but many factors affect their ability to engage and enrol in them. This systematic review aims to identify and synthesise the qualitative literature on barriers and facilitators to engagement and recruitment to DHIs to inform future implementation efforts. Methods PubMed, MEDLINE, CINAHL, Embase, Scopus and the ACM Digital Library were searched for English language qualitative studies from 2000 – 2015 that discussed factors affecting engagement and enrolment in a range of DHIs (e.g. ‘telemedicine’, ‘mobile applications’, ‘personal health record’, ‘social networking’). Text mining and additional search strategies were used to identify 1,448 records. Two reviewers independently carried out paper screening, quality assessment, data extraction and analysis. Data was analysed using framework synthesis, informed by Normalization Process Theory, and Burden of Treatment Theory helped conceptualise the interpretation of results. Results Nineteen publications were included in the review. Four overarching themes that affect patient and public engagement and enrolment in DHIs emerged; 1) personal agency and motivation; 2) personal life and values; 3) the engagement and recruitment approach; and 4) the quality of the DHI. The review also summarises engagement and recruitment strategies used. A preliminary DIgital Health EnGagement MOdel (DIEGO) was developed to highlight the key processes involved. Existing knowledge gaps are identified and a number of recommendations made for future research. Study limitations include English language publications and exclusion of grey literature. Conclusion This review summarises and highlights the complexity of digital health engagement and recruitment processes and outlines issues that need to be addressed before patients and the public commit to digital health and it can be implemented effectively. More work is needed to create successful engagement strategies and better quality digital solutions that are personalised where possible and to gain clinical accreditation and endorsement when appropriate. More investment is also needed to improve computer literacy and ensure technologies are accessible and affordable for those who wish to sign up to them. Systematic review registration International Prospective Register of Systematic Reviews CRD42015029846 Electronic supplementary material The online version of this article (doi:10.1186/s12911-016-0359-3) contains supplementary material, which is available to authorized users.
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                Author and article information

                Contributors
                Journal
                JMIR Rehabil Assist Technol
                JMIR Rehabil Assist Technol
                JRAT
                JMIR Rehabilitation and Assistive Technologies
                JMIR Publications (Toronto, Canada )
                2369-2529
                Jan-Jun 2018
                26 April 2018
                : 5
                : 1
                : e9
                Affiliations
                [1] 1 School of Sport and Exercise Sciences Medway Campus University of Kent Chatham United Kingdom
                [2] 2 Research Department European School of Osteopathy Maidstone United Kingdom
                [3] 3 School of Sport and Exercise Sciences Medway Campus University of Kent Maidstone United Kingdom
                Author notes
                Corresponding Author: Philip Bright philbright@ 123456eso.ac.uk
                Author information
                http://orcid.org/0000-0002-5339-8281
                http://orcid.org/0000-0002-3442-2493
                Article
                v5i1e9
                10.2196/rehab.8567
                5945989
                29699967
                df881818-b0f2-4c35-ae4e-de24765a2576
                ©Philip Bright, Karen Hambly. Originally published in JMIR Rehabilitation and Assistive Technology (http://rehab.jmir.org), 26.04.2018.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Rehabilitation and Assistive Technology, is properly cited. The complete bibliographic information, a link to the original publication on http://rehab.jmir.org/, as well as this copyright and license information must be included.

                History
                : 30 July 2017
                : 23 November 2017
                : 26 February 2018
                : 16 March 2018
                Categories
                Original Paper
                Original Paper

                ehealth; social media; exercise therapy; rehabilitation

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