Publication: Rehabilitación de la artroplastia total de cadera a través de una aplicación móvil : estudio observacional retrospectivo
Authors
Zambrano Martín, Joaquín
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Escuela Internacional de Doctorado
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Gómez Conesa, Antonia ; Mendoza Puente, Miguel ; Méndez Sánchez, Roberto
Publisher
Universidad de Murcia
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DOI
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info:eu-repo/semantics/doctoralThesis
Description
Abstract
Objetivo.
El objetivo de esta tesis fue evaluar la efectividad de un programa de rehabilitación basado en el uso de una aplicación móvil que proporciona ejercicios de recuperación funcional e información educativa sobre el manejo del dolor frente a un programa de rehabilitación presencial de fisioterapia en pacientes sometidos a artroplastia total de cadera. La investigación buscó determinar si el uso de una aplicación móvil podía mejorar los resultados funcionales, evolución del dolor y la satisfacción de los pacientes a los tres meses de la cirugía.
Metodología.
Se realizó un estudio observacional, analítico, longitudinal y retrospectivo con diseño comparativo, que incluyó dos cohortes de 47 pacientes cada una: un grupo seguido mediante una app móvil y un grupo control emparejado mediante Propensity Score Matching (PSM). Las variables analizadas abarcaron características demográficas y clínicas previas a la cirugía, como la edad, el género, el índice de masa corporal (IMC), el nivel de actividad física y la clasificación según la escala ASA. Asimismo, se evaluaron medidas de resultados reportados por los pacientes (PROMs), como las escalas WOMAC, Harris Hip Score (HHS) y la EVA de dolor, junto con la escala funcional de Merle D’Aubigné. Adicionalmente, se consideraron medidas de experiencia del paciente (PREMs) relacionadas con la satisfacción.
La recolección de datos se realizó en tres momentos: prequirúrgico, al mes y a los tres meses postoperatorios, siendo la satisfacción evaluada únicamente en el primer y tercer mes.
El análisis estadístico incluyó pruebas paramétricas y no paramétricas según la distribución de los datos, ANOVA para medidas repetidas, pruebas de Wilcoxon y correcciones de Bonferroni para comparaciones múltiples. Los resultados mostraron mejoras significativas en el grupo de pacientes seguidos mediante la app móvil en comparación con el grupo control en las siguientes medidas de resultado: Harris Hip Score (HHS) a los tres meses (p=0,02), en la Escala Merle D’Aubigné en las dimensiones de movilidad (p=0,02) y capacidad de marcha (p<0,0001) a los tres meses, así como en la diferencia entre medias en la EVA de dolor tanto al mes (p=0,004) como a los tres meses (p=0,01). No obstante, no se encontraron diferencias significativas en los niveles de satisfacción entre ambos grupos.
Conclusión.
El uso de programa de rehabilitación basado en el uso de una aplicación móvil es más efectivo en la recuperación funcional, en términos de movilidad y capacidad de la marcha, así como en la reducción del dolor, en pacientes operados de artroplastia total de cadera, en comparación con un programa de rehabilitación presencial de fisioterapia.
Objective The aim of this thesis was to evaluate the effectiveness of a rehabilitation program based on a mobile application that provides functional recovery exercises and educational information on pain management, compared to an in-person physiotherapy rehabilitation program in patients undergoing total hip arthroplasty. The research sought to determine whether the use of a mobile application could improve functional outcomes, pain progression, and patient satisfaction three months after surgery. Methodology An observational, analytical, longitudinal, and retrospective comparative study was conducted, including two cohorts of 47 patients each: one group followed via a mobile app and a control group matched through Propensity Score Matching (PSM). The analyzed variables included preoperative demographic and clinical characteristics such as age, gender, body mass index (BMI), physical activity level, and classification according to the ASA scale. Additionally, patient-reported outcome measures (PROMs) were assessed, including the WOMAC scale, Harris Hip Score (HHS), and the Visual Analog Scale (VAS) for pain, along with the Merle D’Aubigné functional scale. Patient-reported experience measures (PREMs) related to satisfaction were also considered. Data collection was conducted at three time points: preoperatively, one month postoperatively, and three months postoperatively, with satisfaction being evaluated only at the first and third months. Statistical analysis included parametric and non-parametric tests depending on data distribution, repeated measures ANOVA, Wilcoxon tests, and Bonferroni corrections for multiple comparisons. The results showed significant improvements in the mobile app group compared to the control group in the following outcome measures: Harris Hip Score (HHS) at three months (p=0.02), Merle D’Aubigné Scale in mobility (p=0.02) and walking ability (p<0.0001) at three months, as well as differences in mean VAS pain scores at one month (p=0.004) and three months (p=0.01). However, no significant differences were found in satisfaction levels between the two groups. Conclusion A rehabilitation program based on a mobile application is more effective in functional recovery, specifically in mobility and walking ability, as well as in pain reduction, for patients undergoing total hip arthroplasty, compared to an in-person physiotherapy rehabilitation program.
Objective The aim of this thesis was to evaluate the effectiveness of a rehabilitation program based on a mobile application that provides functional recovery exercises and educational information on pain management, compared to an in-person physiotherapy rehabilitation program in patients undergoing total hip arthroplasty. The research sought to determine whether the use of a mobile application could improve functional outcomes, pain progression, and patient satisfaction three months after surgery. Methodology An observational, analytical, longitudinal, and retrospective comparative study was conducted, including two cohorts of 47 patients each: one group followed via a mobile app and a control group matched through Propensity Score Matching (PSM). The analyzed variables included preoperative demographic and clinical characteristics such as age, gender, body mass index (BMI), physical activity level, and classification according to the ASA scale. Additionally, patient-reported outcome measures (PROMs) were assessed, including the WOMAC scale, Harris Hip Score (HHS), and the Visual Analog Scale (VAS) for pain, along with the Merle D’Aubigné functional scale. Patient-reported experience measures (PREMs) related to satisfaction were also considered. Data collection was conducted at three time points: preoperatively, one month postoperatively, and three months postoperatively, with satisfaction being evaluated only at the first and third months. Statistical analysis included parametric and non-parametric tests depending on data distribution, repeated measures ANOVA, Wilcoxon tests, and Bonferroni corrections for multiple comparisons. The results showed significant improvements in the mobile app group compared to the control group in the following outcome measures: Harris Hip Score (HHS) at three months (p=0.02), Merle D’Aubigné Scale in mobility (p=0.02) and walking ability (p<0.0001) at three months, as well as differences in mean VAS pain scores at one month (p=0.004) and three months (p=0.01). However, no significant differences were found in satisfaction levels between the two groups. Conclusion A rehabilitation program based on a mobile application is more effective in functional recovery, specifically in mobility and walking ability, as well as in pain reduction, for patients undergoing total hip arthroplasty, compared to an in-person physiotherapy rehabilitation program.
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8-nov-2026
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