Digital Physiotherapeutic Elbow-Specific Training System for Patients After Arthroscopic Release of Elbow Contracture: Noninferiority Randomized Controlled Trial.

ملخص الدراسة

208 patients undergoing arthroscopic release for posttraumatic elbow stiffness were randomized to receive a 12-week digital training (DT) program providing individually tailored Physiotherapeutic Elbow-Specific Training (PEST) through the Joymotion system or conventional outpatient clinic-based training (CT) supervised by physiotherapists 3–4 times weekly. The primary outcome was active elbow flexion-extension range of motion (ROM) at 12 weeks. Secondary outcomes included forearm rotation ROM, isometric and dynamic elbow flexion strength, American Shoulder and Elbow Surgeons (ASES) function and pain scores, Disabilities of arm, shoulder & hand (DASH) disability, EQ-5D-5L quality of life, adherence, adverse events, and cost-effectiveness, with outcomes assessed at 4, 12, and 24 weeks. Overall, the results revealed that DT was noninferior to CT for 12-week elbow flexion-extension ROM. Most secondary outcomes were comparable, while DT was associated with substantially lower overall rehabilitation costs. These findings suggest that individually tailored digital rehabilitation can provide a clinically viable, safe, and less costly alternative to conventional outpatient rehabilitation following arthroscopic release of posttraumatic elbow stiffness.