The Oaks: A Mobile Exercise and Education Program for People with Osteoarthritis of the Knee

Project Summary This Fast Track SBIR project long term objective is to develop and test of a minimum viable productMVPof The Oaksa perioperativedigitaleducationassessment and guided exercise software application for adults with osteoarthritis of the kneeKOAawaiting total knee replacementTKRsurgeryThis product is relevant to the mission of the NIA because it addresses the call forDevelopment of technologies to assist in the improvement of physical function and mobility in older persons prior toprehabilitaitonor followingrehabilitationelectiveplaned surgeryThe envisioned MVP is an elegantly simple mobile application that is designed to specifically measure the Centers for Medicare Medicaidandapos sCMSComprehensive Care for Joint ReplacementCJRrequired assessments and physical performance assessments prior to and following TKRprovide educational content typically contained in pre operative TKR classes and track recovery of function fordays following TKR surgeryThis product was conceived in response to four main driversthe growing number of adults aging with KOA needing TKRthe need for developing improved patient care perioperatively for TKR surgeriesthe finding that attending educational classes and performing strengthening exercises prior to TKR improves outcomes and lowers post surgical medical utilization potentially saving billions of dollars andthe CMS CJR rule requiring healthcare systems to reduce the cost of care delivery for TKR surgerieswithin a diminishing bundled paymentThis application is very timely and has great potential for widespread adoptionas it will be designed based on end user feedbackfrom all stakeholder groups including people with KOA and the medical care teamBroad ObjectiveWe intend to translate existing evidence based educational materialassessments and exercises to a mobile device for widespread dissemination and adoption to prevent functional decline pre and post operativelypromote health and wellbeing and improve patient care and outcomes through coordinated higher quality of careApproachIn Phase I we willemploy user centered design methodologies to develop a minimum viable productMVPAlpha version of The Oaks for adults over agewith TKR surgery andidentify and evaluate feature and content expansions adaptations for The Oaks Beta MVPIn Phase II we willemploy user centerediterative design approaches to develop The Oaks Beta MVP and we willcomplete feasibilityusabilityand a pilot effectiveness studyResearch DesignWe will use a between subjectsway ANOVAApp No Apprepeated measurespre post surgerydesign to determine feasibilityusability and effectivenesspilot dataof The OaksParticipants will self select class no class and then be randomized to AppGroupor No appGroupstratified by class no classExpected OutcomesWe believe that The Oaks will be a feasible and usable adjunct to TKR for KOA perioperatively and fordays post surgeryThe app will provide healthcare professionals with important data regarding function while reducing the cost of care delivery