Rotator cuff tears are the primary cause of shoulder disability in adults, generating between $3 and $12 billionin healthcare costs annually. Rotator cuff repair (RCR) surgery results in greater improvement than non-surgicaloptions. However, post-RCR rehabilitation requires a careful balance of movement to prevent shoulder stiffnesswhile keeping the shoulder stable to protect repair integrity. Current early rehabilitation involves passive rangeof motion exercises performed during out-patient physiotherapy.Together, Älizur and the University of Pittsburgh propose to develop CuffLink, a telehealth system for post-RCRrehabilitation, by integrating two previous successful developments: the mechanical Strengthening &Stabilization Systems (SSS) and the remote monitoring capabilities of interACTION (iA). CuffLink will aid post-RCR rehabilitation by providing a safe, reliable and at-home means of mobilizing the shoulder, while allowing forremote monitoring. This reduces the need for costly in-patient visits in the early stage of rehabilitation, increasesaccessibility to care for patients with limited mobility and/or in rural areas, and increases communication andsupervision by physicians and their staff through the clinician portal.First, a Delphi survey will be conducted with orthopaedic surgeons and physical therapists to understand theiropinions on the current RCR best practices. Concurrently, an integrated movement monitoring applicationprogramming interface will be developed and refined according to the consensus established by the expertDelphi panel. This will result in the conversion of raw data signals from quantitative motion sensors in the SSSinto clinically acceptable and telehealth ready data streams. Then, a mobile health system based on iA will bedeveloped. This will include an app suite for patients and a clinician portal, which will provide exercise feedbackto both patients and clinicians, and allow clinicians to monitor patient data and engage patients.Then, the accuracy and test-retest reliability of CuffLink will be validated using a group of RCR patients recruitedprimarily through the UPMC Orthopaedic Surgery clinics. Measured readings from CuffLink will be compared toa gold standard optical motion capture system, and participants will return to the testing facility a few days laterto repeat the exercises. Finally, the feasibility, usability, and acceptability of CuffLink for use in patients' homeswill be assessed. These will be evaluated both quantitatively and qualitatively, and the results are expected todemonstrate high satisfaction.Successful completion of this project will result in a device that combines the safety of mechanical motionexercise equipment with quantitative motion tracking and remote monitoring to personalize and optimize patientrecovery from RCR surgery at lower costs. It is expected that the device, CuffLink, will be ready for clinicalevaluation in a Phase II proposal.
Public Health Relevance Statement: NARRATIVE
Rotator cuff tears are the primary cause of shoulder disability in adults, and are commonly treated surgically.
Early post-operative rehabilitation aims to protect the repair and promote healing while safely and progressively
restoring motion, primarily through outpatient physical therapy. We propose to develop CuffLink, a telehealth
system that will allow post-operative patients to perform remotely monitored rehabilitation exercises safely at
home, resulting in cost savings, more efficient use of clinician time, and improved patient adherence and
recovery.
Project Terms: <21+ years old> | |
