Clinical Utility and Patient Compliance With Mobile Applications for Home-Based Rehabilitation Following Transforaminal Lumbar Interbody Fusion

Abstract

Study Design Retrospective chart review. Objectives Transforaminal lumbar interbody fusion (TLIF) via open or minimally invasive (MI) techniques is commonly performed. Mobile applications for home-based therapy programs have grown in popularity. The purpose of this study was to (1) compare patient-reported outcome measures (PROMs) between postoperative patients who were the most and least compliant in using the mobile-based rehabilitation programs, (2) compare PROMs between open vs MI-TLIF cohorts, and (3) quantify overall compliance rates of home-based rehabilitation programs. Methods A retrospective chart review was performed. Patients were automatically enrolled in the rehabilitation program. Patient-Reported Outcomes Measurement Information System (PROMIS) and Oswestry Disability Index (ODI) scores were collected. Patients were separated into two study groups. Compliance rate was calculated as the difference between the number of active participants at the preoperative phase and final follow-up. Results 220 patients were included. Average follow-up time was 23.2 months. No difference was found in the change in (∆) PROMIS scores ( P = 0.261) or ∆ODI scores ( P = 0.690) regardless of patient compliance. No difference was found in outcome scores between open vs MI-TLIF techniques stratified by download compliance (downloaded, DL+; did not download, DL-) and phone reminder compliance (set reminder, R+; did not set reminder, R-) postoperatively. Both cohorts demonstrated clinical improvement exceeding minimal clinically important difference at final follow-up. Overall patient compliance was 71% at final postoperative follow up. Conclusion Despite high long-term compliance and rising popularity, mobile applications for home-based postoperative rehabilitation programs have low clinical utility in patients undergoing TLIF.