Post-Operative Range of Motion Exercises Performed Most Days at 50% Maximum ROM with Recupe Digital Health Improved ROM Recovery and Reduced Complications

Range of Motion (ROM) exercises are common after knee surgeries, but little has been researched about the actual amount of movement performed in active exercises at home. This was previously difficult to measure, as the patient was not in the office. But now, with wearables used during home exercises, Plethy Recupe, a digital health platform, was able to shed some light on whether full ROM is required for post-operative ROM exercises after Total Knee Arthroplasty (TKA).

This study involved 170 TKA patients performed by the same orthopedic group. Demographics, such as age, gender, and BMI, office visits, and physical therapy care were all similar. For patients using Recupe, exercises were performed and average of 4.84 days per week. Recupe used a mobile app to direct exercises, and a wearable to measure the ROM. The ROM performed by these patients during home exercises ranged from 46.9 (sd 19.3) degrees in the first two weeks post-op, to 50.6 (sd 23.0) degrees at 1 month post-op. Meanwhile, the maximum ROM, as measured by the orthopedist, rose from 114 (sd 10.76) degrees before surgery, to 120 (sd 9.08) degrees at 1 month post-op.

These are vastly different numbers, greater than 2 SD, and the home exercises show a great deal more variation. What is clear though is the fact that the patient did not bend their knees anywhere near the maximum range. Still, these patients experienced significantly better knee flexion recovery compared to patients at the same center who did not use Recupe, averaging 120 degrees versus 114 degrees. Also, patients using Recupe experienced significantly fewer Manipulation Under Anesthesia (MUA) complications, 2% versus 5%. As the other variables were similar for patients using Recupe and those who did not, the likely cause for these differences was frequency of home exercise performance. However, there is not a measurement of the home exercise frequency for those patients not using digital health.

So, from this data, it appears that bending post-surgical knees to full range is not required for recovery. Instead, it appears that the key is exercise plan adherence, where the Recupe group performed exercises around 5 times per week.