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A Psycholgical Intervention Delivered by Automated Mobile Phone Messaging Stabilized Hip and Knee Function During the COVID-19 Pandemic: A Randomized Controlled Trial.
Anthony, Chris A; Rojas, Edward; Glass, Natalie; Keffala, Valerie; Noiseux, Nicholas; Elkins, Jacob; Brown, Timothy S; Bedard, Nicholas A.
  • Anthony CA; Department of Orthopaedics, University of Pennsylvania, Philadelphia, PA.
  • Rojas E; Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, IA.
  • Glass N; Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, IA.
  • Keffala V; Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, IA.
  • Noiseux N; Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, IA.
  • Elkins J; Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, IA.
  • Brown TS; Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, IA.
  • Bedard NA; Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, IA.
J Arthroplasty ; 37(3): 431-437.e3, 2022 03.
Article in English | MEDLINE | ID: covidwho-1682921
ABSTRACT

BACKGROUND:

We conducted a randomized controlled trial to evaluate the effectiveness of acceptance and commitment therapy (ACT) delivered via a mobile phone messaging robot to patients who had their total hip arthroplasty or total knee arthroplasty procedures postponed due to the COVID-19 pandemic.

METHODS:

Ninety patients scheduled for total hip arthroplasty or total knee arthroplasty who experienced surgical delay due to the COVID-19 pandemic were randomized to the ACT group, receiving 14 days of twice daily automated mobile phone messages, or the control group, who received no messages. Minimal clinically important differences (MCIDs) in preintervention and postintervention patient-reported outcome measures were utilized to evaluate the intervention.

RESULTS:

Thirty-eight percent of ACT group participants improved and achieved MCID on the Patient-Reported Outcome Measure Information System Physical Health compared to 17.5% in the control group (P = .038; number needed to treat [NNT] 5). For the joint-specific Hip Disability and Osteoarthritis Outcome Score Joint Replacement and Knee Disability and Osteoarthritis Outcome Score Joint Replacement (KOOS JR), 24% of the ACT group achieved MCID compared to 2.5% in the control group (P = .004; NNT 5). An improvement in the KOOS JR was found in 29% of the ACT group compared to 4.2% in the control group (P = .028; NNT 5). Fourteen percent of the ACT group participants experienced a clinical important decline in the KOOS JR compared to 41.7% in the control group (P = .027; NNT 4).

CONCLUSION:

A psychological intervention delivered via a text messaging robot improved physical function and prevented decline in patient-reported outcome measures in patients who experienced an unexpected surgical delay during the COVID-19 pandemic. LEVEL OF EVIDENCE 1.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Arthroplasty, Replacement, Hip / Osteoarthritis, Knee / Cell Phone / Acceptance and Commitment Therapy / COVID-19 Type of study: Experimental Studies / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: J Arthroplasty Journal subject: Orthopedics Year: 2022 Document Type: Article Affiliation country: J.arth.2021.12.006

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Arthroplasty, Replacement, Hip / Osteoarthritis, Knee / Cell Phone / Acceptance and Commitment Therapy / COVID-19 Type of study: Experimental Studies / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: J Arthroplasty Journal subject: Orthopedics Year: 2022 Document Type: Article Affiliation country: J.arth.2021.12.006