Exploring Innovative Rehabilitation for the Knee using Ehealth, Biofeedback and Online Communities

Knee pain is regarded as an inevitable outcome in an ageing population and subsequent management, treatment and rehabilitation may exacerbate demand on stretched health services globally. Knee pain can be influenced by a number of factors; gender, body mass, activity profile, arthrokinematics, patient biopsychosociology and predisposing injury or trauma. Treatment options are typically viewed as pharmacological and non-pharmacological. Exercise and physical therapy are key elements within the latter option, alongside surgical procedures. Knee pain sufferers may vindicate their condition through clinical diagnosis and shift of locus of control; compliance to exercise interventions can depend on the scope of this shift. Such values should be acknowledged when monitoring individualised progression in the management of knee pain. Technology may have a role to play in capturing and influencing compliance within the scope of knee rehabilitation.

The main aim of this thesis was to explore the use of innovative rehabilitation interventions for the knee that integrated eHealth, biofeedback and online communities. As this constitutes a complex scenario, this thesis has been reported using elements of the Medical Research Council (MRC) framework for the development and evaluation of complex interventions to improve health (Blackwood et al., 2010; Craig et al., 2008); notably the Preclinical (theory) stage, the Phase I (modelling) stage, and Phase II (exploratory trial). The findings further inform the options for rehabilitation around knee pain, encompassing latest generation techniques for addressing progressive joint disease and eHealth initiatives. These also included options for self-management and reporting that could be generalised to knee pain sufferers; an approach informed by the exploration of the reported experiences of individuals engaging with an online health community for knee pain. The eHealth component of the thesis looked to explore the use of simple Web 2.0 solutions and readily available domiciliary equipment for efficacy and accessibility.