Abstract
Background: Rehabilitation of lower limb prosthetics involves long-term follow-up following the fitting of the prosthetic, but a significant number of users have barriers to travel, cost, mobility, and communication, which restrict access to timely care. Tele-rehabilitation using Smartphone can be used as an extension of regular follow-up that can substitute face-to-face prosthetic services.
Purpose: In this study, an effective smartphone-based follow-up model was developed and evaluated in lower limb prosthetic users.
Approaches: A pre-post developmental design compared to pre-intervention was employed. Fifty prosthetic users of lower limbs were screened and 40 eligible and 35 with a 6-week follow-up. The model adopted conventional smartphone applications, such as WhatsApp or video calls, SMS notices, workout instructions, activity, prosthetic care, messages of motivations and safety reporting instructions. Outcomes consisted of QUEST 2.0 satisfaction scores, weekly adherence, average daily steps, perceived effectiveness, participant feedback, and any safety concerns.
Findings: Barriers to traditional follow-up were reported by participants, typically due to distance to travel, travelling difficulty with a prosthesis, the cost of travelling, shortage of specialists, latent communication with clinicians, and cancellation or lateness of appointments. The mean QUEST score in the tele-rehabilitation condition rose to 4.20 opposed to no tele-rehabilitation condition, which rose to 3.00 to 3.40. Six weeks of tele-rehabilitation condition showed an increase of 3,200 on average daily steps to 4,800 and adherence rose as well by 62 to 89 percent. There were also high scores on perceived usefulness, particularly the willingness to recommend the model and better access to follow-up care.
Conclusion: There was evidence that a low-burden smartphone-based follow-up model was safe, acceptable, and supportive in lower limb prosthetic users. It should be placed in a supportive position to, not a substitute of face-to-face prosthetic and rehabilitation care