Use of Mobile App to Enhance Geriatric Hip Fracture Rehabilitation

Use of Mobile App to Enhance Functional Outcomes and Adherence of Home-based Rehabilitation Program for Elderly With Hip Fracture: A Randomized Controlled Trial

The steady increase in the incidence of geriatric hip fracture places an increasing burden on health care service in Hong Kong. Post fracture limitations are prominent and restrain many of the elderly from returning to community, rehabilitation is therefore important for reducing their long-term disability.

By integrating the results from pilot application of video guided training and tele-physiotherapy program in different phases of rehabilitation, a Mobile Application (app) is developed aiming to improve hip fracture patients' and their carers' experience throughout the healthcare journey and empower them to manage their own health. A steering group comprised of physiotherapists, informatics and university research expert is formed to co-design the app, compose education content and formulate the promulgation and evaluation strategies. Meetings are also held with all involved clinicians to refine the app before implementation.

This app provides features for hip fracture rehabilitation including "Understanding Hip Fracture", "Hip Fracture Care", "Training" and "Companion". Patients and their carers can obtain hip fracture care related information through the app anywhere, anytime, instead of coming to the clinics in person or reading the information on pamphlets. Physiotherapists can use the app to set training program for discharged patients with "Push Reminder" function and training record can be saved in "Progress Summary", which facilitates them and carers to get a grip on the patients' rehabilitation progress.

Clinical study is therefore planned to be conducted to evaluate the effectiveness of the app from different perspectives, including the users' acceptance and satisfaction, patients' program compliance and functional recovery.

Inclusion Criteria:

All participants who completed the inpatient Geriatric Hip Fracture Rehabilitation Program in the Department of Orthopedic Rehabilitation (DOR) of TPH will be recruited by convenience sampling before discharge. To be eligible for enrolment, participants should:

1. have a primary diagnosis of hip fracture,
2. be 60 to 90 years old,
3. be literate enough to read and understand simple questions in Chinese,
4. be discharged home and taken care by caregiver,
5. have at least level III measured by Modified Functional Ambulatory Category (MFAC) upon discharge,
6. have access to a smart phone or tablets (iOS or Android platform)
7. have signed the written informed consent.

Exclusion Criteria:

Participants will be excluded from the study if they:

1. have a bilateral hip fracture or hip fracture is the result of a malignancy,
2. have significant cognitive deficits,
3. have significant cardiopulmonary contraindications or preexisting conditions that precluded participation in an exercise program,
4. have a terminal illness (survival expected to be <1 year),
5. have severe visual deficits or legally blind,
6. have request that their participation be terminated. All eligible participants will be given a detailed explanation and ethics approval will be obtained from the Joint CUHK-NTEC CREC prior to commencing the study.