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The aim of this study is to investigate the effectiveness of a smartphone-based e-health application (intervention group) compared with standard care (control group) in terms of changes in adherence in patients with knee osteoarthritis using the EARS questionnaire. In addition, other questionnaires presented in the appendix (KOOS, TSK, EPAP, EQ-5D-3L, pain) will be given to all patients in order to meet the secondary evaluation criteria.
Knee osteoarthritis is the most common joint disease affecting the joint itself as well as the peri-articular structures in a global and progressive manner. It can affect all the joints of the body, with a predominance for those which undergo strong mechanical constraints such as the rachis, the hip or the knee. It is a chronic pathology correlated with age, since nearly one adult in two is affected by osteoarthritis.
Today, connected objects have taken a predominant place in the daily life of the majority of the population, including seniors. It is an object of communication and socialization as well as a major information tool. E-health applications are more and more numerous in the stores and are a tool for assistance, information and support already used in many fields. In the context of therapeutic education, it is a motivational tool that can accompany patients by adapting to their needs and progress compared to traditional self-exercise methods. Studies of the obstacles and levers for the use of smartphone applications in chronic pathologies such as low back pain support the development of this tool.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control | No Intervention | Standard care | |
| Experimental group | Experimental | Standard care and participants use the ARTH-e application for 6 months |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Application ARTH-e | Other | The ARTH-e application must be downloaded via the PlayStore or Applestore platform on phone and/or tablet. Once the application has been downloaded, the patient must scan a QRcode sent by the CHU to anonymize the data. Participants will have 6 months to use the application at their convenience. |
| Measure | Description | Time Frame |
|---|---|---|
| Exercise Adherence Rating Scale | This questionnaire, validated in French, comprises 6 items. Scoring is based on a 5-point Likert scale (from 0 - "completely agree" to 4 - "completely disagree"). This results in a score ranging from 0 to 24. A higher score indicates greater support. The evolution of the score (i.e. the kinetics) will be compared between randomisation groups using a mixed model, taking into account the group, time and time x group interaction effects; it is therefore the value of EARS and not a variation that will be considered for the analysis. | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Exercise Adherence Rating Scale | This questionnaire, validated in French, comprises 6 items. Scoring is based on a 5-point Likert scale (from 0 - "completely agree" to 4 - "completely disagree"). This results in a score ranging from 0 to 24. A higher score indicates greater support. The evolution of the score (i.e. the kinetics) will be compared between randomisation groups using a mixed model, taking into account the group, time and time x group interaction effects; it is therefore the value of EARS and not a variation that will be considered for the analysis. |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHU Clermont-Ferrand | Clermont-Ferrand | France | ||||
| CH Emile Roux |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39832974 | Derived | Pelletier-Visa M, Dobija L, Bonhomme A, Lanhers C, Pereira B, Coudeyre E. Effectiveness of the ARTHE-e app for exercise adherence in people with knee osteoarthritis: protocol for a randomised controlled trial. BMJ Open. 2025 Jan 20;15(1):e088860. doi: 10.1136/bmjopen-2024-088860. |
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| ID | Term |
|---|---|
| D020370 | Osteoarthritis, Knee |
| D000544 | Alzheimer Disease |
| ID | Term |
|---|---|
| D010003 | Osteoarthritis |
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
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The investigators plan to conduct a multicenter, prospective, comparative, randomised trial (1:1). Participants will be randomized to one of two groups: control or experimental. In each group (control or experimental), each participant will be able to use the application for a period of 6 months.
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The investigating physician who will carry out the inclusion visit will know the result of the randomization which will be carried out during the consultation. The second evaluator, who will carry out the end-of-study visit, will not know the patient's group. As a result, the assessment will be neutral and the second assessor will evaluate the patient without being influenced by the study group.
|
| 2 months and 4 months |
| EPAP questionnaire | Identification of barriers and levers to regular physical activity using the EPAP questionnaire. This questionnaire contains 24 items on the facilities and obstacles encountered when engaging in physical activity. The maximum score for this questionnaire is 100 points. Responses range from "Strongly disagree" (0 points) to "Strongly agree" (4 points). Responses to this questionnaire will be collected at inclusion and at the end of the study. | Inclusion and 6 months |
| TSK questionnaire | Evaluation of fears and anxieties related to pain that may be experienced during physical exercise using the TSK questionnaire at inclusion and at the end of the study. This questionnaire contains 17 statements. Patients were asked to circle the number that best corresponded to them (4 points). Responses ranged from "Strongly disagree" (1 point) to "Strongly agree" (4 points). The maximum score is 68. The higher the score, the greater the level of kinesiophobia. | Inclusion and at 6 months |
| Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire | Comparison of the functional evaluation collected at inclusion and at 6 months of use of the application via the Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire. This questionnaire consists of 17 statements answering the question "Over the last eight days, how difficult́ have you beeń doing each of the following activities?". Responses range from "absent" (0 points) to "extreme" (4 points). The maximum score is 68. A high score is predictive of functional deterioration. | Inclusion and 6 months |
| EQ-5D-3L questionnaire | Evaluation of quality of life using the EQ-5D-3L questionnaire. This questionnaire consists of two aspects: a descriptive system (EQ-5D) and a visual analogue scale (EQ-VAS). The questionnaire comprises five dimensions: mobility, personal care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 3 levels: no problems, a few problems and extreme problems. The patient therefore ticks the box that seems most appropriate to their current state. | Inclusion and at 6 months |
| Mobility | Measurement of joint mobility with a goniometer (flexion/extension) | Inclusion and at 6 months |
| Average number of steps per day | Collection of average number of steps per day for 6 months during telephone calls (every 2 months). The GARMIN connected bracelet will allow us to collect the number of average steps per day (four measurement times over one week before each evaluation: inclusion, 2 months, 4 months and 6 months) via its GARMIN connect application. | Inclusion, 2,4,6 months |
| Parameters for use of the ARTHE application | Collection of parameters for use of the ARTHE application, if applicable (for the intervention group), the number of sessions carried out per week will be collected by extracting data from the application's production back office. | 2,4,6 months |
| Functional tests - 30 sec chair lifts | Functional tests: number of 30-second chair lifts at inclusion and at 6 months.The patient should remain in the sit-to-stand position for as long as possible (30 sec). The evaluator counts the number of sit-ups performed. | Inclusion and 6 months |
| Functional tests - Stair Climbing Test | Functional tests: Stair Climbing Test (in seconds) at inclusion and at 6 months. The patient will be asked to climb 1The patient will be asked to climb 11 steps (height 13.5cm), make a U-turn and descend them as quickly as possible, while maintaining safety during the test (no loss of balance). Climbing and descending time will be measured separately with a stopwatch. 1 steps (height 13.5cm), make a half-turn and descend them as quickly as possible, but keeping safe during the test (without loss of balance). Climbing and descending times will be measured separately with a stopwatch. | Inclusion and 6 months |
| Functional tests - 6MWT | Functional tests: 6-minute walk test (6 MWT) (in meters) at inclusion and at 6 months.This test carried out in a corridor with pads numbered from 1 to 60. The patient must walk back and forth for 6 minutes. The examiner measures the distance covered during these 6 minutes. | Inclusion and 6 months |
| Functional tests - quadriceps isometric strength test with dynamometer | Functional tests: quadriceps isometric strength test (in N/Kg)with a dynamometer at inclusion and at 6 months. The participant will be asked to push the leg forward as hard as possible (isometric contraction of the quadriceps) for 5 seconds. Three trial contractions will be performed with progressive effort (weak, medium and strong). Then, three consecutive maximum contractions will be recorded using a dynamometer. The maximum value will be recorded and normalized in relation to the patient's body mass [N/kg]. | Inclusion and 6 months |
| Medico-economic analysis | Medico-economic analysis carried out using a data record (drug management, medical consultations, hospitalisations, use of alternative therapies, additional examinations, use of medical transport). | Inclusion and 6 months |
| Pain Visual Analog Scale | Change in the average level of pain over the last 3 days collected during the telephone interview using a 10-point Numerical Scale (0 = "No pain" to 10 = "Maximum imaginable pain") at inclusion, 2 months, 4 months and 6 months of use of the application. | Inclusion, 2 months, 4 months and 6 months |
| Le Puy-en-Velay |
| France |
| CHU Montpellier | Montpellier | France |
| CHU Nantes | Nantes | France |
| D012216 |
| Rheumatic Diseases |
| D003704 | Dementia |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D024801 | Tauopathies |
| D019636 | Neurodegenerative Diseases |
| D019965 | Neurocognitive Disorders |
| D001523 | Mental Disorders |