iGetBetter: A new way to recover from knee replacement surgery
With proper pre-operative conditioning and post-operative rehabilitation, patients who undergo knee replacement surgery are able to regain their quality of life, often enjoying many of the activities in which they were once unable to participate in. However, many patients feel lost when it comes to preparing for surgery and struggle to make the most of their physical therapy after surgery. For patients at Brigham and Women’s Faulkner Hospital, a new tool called iGetBetter is available to simplify the process.
iGetBetter is a cloud-based application that provides patients with clear treatment plans and allows physicians to remotely monitor their patients’ clinical status on a daily basis. Best of all, it’s easy to use. Patients get daily email notifications reminding them to log on to do their exercises both before and after surgery. The program provides care instructions in the form of pain and wound management, physical therapy videos and questions designed to identify signs and symptoms of surgical complications. The most convenient part is that patients are able to perform their tasks at home, at their convenience. For physicians, the program encourages patient engagement and helps to optimally prepare them for surgery.
“It’s so much more than just giving a patient instructions and letting them figure out what to do on their own,” says Dr. Wolfgang Fitz, an orthopedic surgeon at BWFH who specializes in knee replacement surgery. “The physician can be in control of what their patient is doing and adjust as necessary. If I see that a patient is able to fulfill the minimum requirements, I can raise them to the medium level. Then, if they can do that, I can advance them even further.”
For the patient at home, the program provides a gentle reminder each day about the importance of completing their exercises. One patient, a 63-year-old woman who describes herself as “not an exercise person,” found the iGetBetter application to be just what she needed to stay motivated. “It’s really been a positive experience,” she said just one week after surgery. The pre-operative conditioning meant she went into surgery feeling mentally and physically prepared. “You feel good about what you as a patient can do,” she says. “You have a feeling of empowerment and that you have control over your body.” After surgery, she is looking forward to kayaking again.
With the help of BWFH’s Rehabilitation Services Department, the care plans patients use in iGetBetter are tailored for optimum results. “We have developed a pre-operative evaluation and exercise program for Dr. Fitz’s patients that they begin three months prior to surgery,” says Director of Rehabilitation Services Jean Flanagan Jay, PT, DPT, CLT. “During the evaluation balance, strength, motion and function are tested. The patient is then assigned their appropriate exercises.”
These exercises include proprioceptive exercises, which teach the body to control the position of a deficient or an injured joint. “It’s really novel,” says Dr. Fitz. “Proprioceptive exercises are not part of the standard knee pathway preoperatively, but we’ve incorporated them. There are several studies that show that if you do proprioceptive exercises before surgery, your proprioception after surgery is better and you have less falls.”
For the patient, it’s just about starting slow and seeing results. “I really, really think it’s wonderful,” she says. “It doesn’t feel onerous.”