Feasibility and Preliminary Effectiveness of a Mobile App–Based Personalized Exercise Program in Older Patients With Chronic Knee Osteoarthritis: Pilot Randomized Controlled Trial

Abstract

Background: Knee osteoarthritis is a prevalent cause of disability among older adults, emphasizing the need for effective and accessible self-management strategies. Mobile app–based personalized exercise programs predominantly overcome the barriers associated with traditional approaches. Objective: This study aimed to evaluate the feasibility and preliminary efficacy of a 6-week mobile app–based self-exercise program that incorporates a multimonitoring system, weekly progress tracking, and dynamic exercise adjustments used by physiotherapists, and compares them with those of a conventional paper-based self-exercise program in older patients with chronic knee osteoarthritis. Methods: A total of 29 participants aged ≥60 years with chronic knee pain and radiographic evidence of osteoarthritis were randomized at a 2:1 ratio to either the intervention (19/29, 66%; mobile app–based program) or control (10/29, 34%; paper-based program) group. The mobile app delivered a personalized exercise program, which was tailored by physiotherapists based on remote monitoring of patient-reported symptoms. Feasibility outcomes included retention, adherence, and satisfaction rates, as well as safety. Preliminary clinical outcomes included changes from baseline to 6 weeks in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total score, Numeric Rating Scale (NRS) pain, and other functional measures. Results: A total of 26 participants (n=16, 62% intervention and n=10, 38% control) completed the 6-week assessment, with retention rates of 84% and 100%, respectively. No adverse events were reported. Adherence was high in the intervention group, with 69% exercising ≥5 days per week and 88% reporting high satisfaction. The intervention group exhibited significant reductions in the WOMAC total score (median change –11.00, 95% CI –23.00 to −2.50; P=.01) and NRS pain score (mean change –2.12, 95% CI –3.13 to −1.11; P