Web-based exercise prescription to provide home exercise programmes

Patients attending MSK physiotherapy outpatients are regularly provided with supporting material documenting physiotherapy home exercise programmes and advice to adhere to in order to optimise their rehabilitation outcomes.

Situation

The Guy’s & St Thomas’ NHS Foundation Trust (GSTT) physiotherapy department currently only has the capacity to provide supporting material to patients which are handwritten / self-drawn by therapists or from published booklets approved by the Trust or external organisations.

Aspiration

Deploy a digital platform for healthcare practitioners to provide home exercise programmes and track patient adherence.

Solution and impact

Guy’s & St Thomas’ NHS Foundation Trust physiotherapy outpatients have implemented a web-based and mobile application exercise prescription programme called Physitrack.

How it was implemented

  • Patient is seen in fracture clinic and it is established if they meet inclusion/exclusion criteria and they consent to Physitrack trial
  • Physiotherapist selects exercise programme for patient on Physitrack. Patient is told to complete programme as per agreed frequency
  • Patient is sent an email with instructions to how to complete exercise programme on Physiapp or via web browser. PDF print out is also available
  • Patient completes exercise programme with ability to view videos of exercises via mobile app or web browser. There is functionality to add reminders
  • On physiotherapy follow-up, patient adherence is recorded and patient satisfaction, and experience questionnaire is completed

Impact

Patient experience and engagement with clinicians and the service was improved by using a digital platform to deliver exercise. Exercise adherence was able to be digitally tracked on “PhysiApp” and was shown to be in line with previous research into self-completed musculoskeletal rehabilitation. Clinicians' engagement with the system may also be a factor when considering the effectiveness of digital exercise prescription programmes.

Functionality

  • Manage content delivery, notifications and engagement in iOS, Android and web apps replacing emails, PDFs or handouts
  • Patients download the PhysiApp patient app to follow perfect form exercise videos and report back on their progress, both online and offline
  • In-app reminders keep patients on track and motivated, while the optional instant messaging feature allows clinicians to stay in touch with their patients in real-time.

Capabilities

  • Home exercise prescription
  • Patient education
  • Outcome measure capture

Scope

  • Digital alternative to standard materials documenting physiotherapy home exercise programmes
  • Provision of patient education via video or PDF
  • Automated outcome measure capture and evaluation

Key figures/quotes

  • 19 of the 39 patients enrolled in the trial (48.72%) engaged in Physitrack via their requested method of exercise prescription. The most common method used was PhysiApp (over web browser or PDF)
  • For patients who used Physitrack the average level of exercise adherence was 2.87 x weekly. For patients that attended their follow-up appointment, average adherence increased to 3.78 x weekly
  • 15 questionnaires were completed by patients that utilised Physitrack. From the digital content Physitrack offers, approximately 93% of patients found videos either ‘fairly useful’ or ‘very useful’. Approximately 86% of patients ‘agreed’ or ‘strongly agreed’ that Physitrack was easy to use, felt confident using the app and found the way the exercises were provided to be convenient
  • For staff that utilised Physitrack (n=3) 100% ‘agreed’ they would like to use Physitrack frequently with patients

Find out more

Read more on the exercise programme here

Visit the Physitrack website here

Key contact

Jack Grodon, senior specialist musculoskeletal physiotherapist / fracture clinic team lead, Guy’s and St Thomas’ NHS Foundation Trust

Jack.Grodon@gstt.nhs.uk