ABSTRACT
Knee replacement operations are common, highly successful procedures that are increasing in frequency. The COVID-19 pandemic has emphasized the need for innovative care pathways that reduce face-to-face appointments. We report on the impact of introducing a wearable sensor for pre- and postoperative rehabilitation of 21 knee replacement patients at 2 hospitals in the U.K. Methods: The sensor (BPMpathway; 270 Vision) was provided during joint school prior to knee replacement and stayed with the patient until a maximum of 9 weeks post-surgery. Participant progress and exercise were monitored remotely, with exercise regimens altered as required. Participants and clinicians could communicate remotely via the device. Results: The median range of motion during the first week post-surgery was 63° (interquartile range [IQR] = 21°) and increased to 136° (IQR = 16°) by week 7. The rate of participant compliance with exercises using the device was 32.3% for thrice-daily compliance and 52.4% for once-daily compliance. The 2-way communication channel was well utilized by both participants and clinicians. We report a 35.7% reduction in face-to-face physiotherapy appointments compared with standard practice. Finally, >80% of users who completed the feedback questionnaire reported a positive experience using the device, finding it easy to understand and reporting that it motivated them to perform their exercises. Conclusions: The use of BPMpathway was well received, effective, and reduced face-to-face physiotherapy appointments. Clinical Relevance: Remote monitoring can reduce the burden to the outpatient physiotherapy service by supporting the post-COVID-19 surgical service recovery plans of the National Health Service and allowing patients to recuperate at home.
ABSTRACT
The COVID-19 pandemic and the measures put in place to control its spread resulted in a collapse in global economic activity. Both governments and central banks responded to the deep economic crisis with unprecedented policy interventions. In this paper, we use both a global and a domestic structural macroeconomic model to estimate the impact of these exceptional policy supports on the international economy and on Ireland. Our analysis seeks to quantify the positive spillovers to the Irish economy from the fiscal, monetary and macroprudential policy interventions introduced globally and describes the transmission channels through which these policy actions affect Ireland. We also estimate the impact on economic activity and the labour market of the unprecedented fiscal packages introduced in Ireland. Our results indicate that the combination of international and domestic policy interventions have helped to substantially reduce the fall in output in Ireland from COVID-19, boosting growth in 2020 by up to 8 percentage points.