Determine if a mobile app alongside a home strength program improves exercise adherence and/or function in knee osteoarthritis. 2-arm superiority randomized clinical trial in adults with knee osteoarthritis and physical dysfunction. Both groups received physiotherapist-prescribed strength exercises (prescribed thrice weekly). Intervention group also received the 'My Exercise Messages' app (provides exercise tracking, goal-setting and behavior change messages). Two self-reported primary outcomes measured: i) number of days exercises were performed over prior fortnight (ordinal outcome dichotomized as "complete adherence" [score 6 or more] or "incomplete adherence" [scores 0 to 5]) and ii) change in function (Western Ontario and McMaster Universities Osteoarthritis Index, 0-68), at 14 weeks (secondary end-point) and 26 weeks (primary end-point). Secondary outcomes included knee pain; sport/recreation function; knee-related quality of life; physical activity; exercise self-efficacy; global change; satisfaction; another exercise adherence measure; and joint replacement willingness. Of 182 people (mean (SD) age 63.5 (8.1) years, 126 (69%) women) randomized, 171 (94%) and 173 (95%) provided primary outcomes at 14 and 26 weeks respectively. At 26 weeks, the exercise plus app group were more likely to be completely adherent (n=31 (36%) versus n=14 (16%) in exercise only) to prescribed exercise frequency (relative risk [95% CIs], 2.1 [1.4, 3.2], p<0.001) but function was not different (mean difference [95% CIs], -0.9 [-3.9, 2.12], p=0.52). Results were similar at 14 weeks. Secondary outcomes did not differ, except Exercise Adherence Rating Scale, favoring exercise plus app. The app improved exercise adherence but this did not translate into improved function.

Hospitalised, unwell patients have vital signs such as heart rate (HR), oxygen saturation (SpO₂) and temperature measured multiple times a day to detect clinical deterioration and monitor health trajectories. Advancements in contact-free (ambient) sensors (AS) to measure vital signs can help mitigate risks due to skin injury and infection transmission seen in conventional hospital equipment. This prospective, observational clinical study aims to validate vital sign measurements from a multi-channel AS compared to conventional equipment in three cohorts: patients in a hospital ward, patients at home within a Hospital-at-Home service, and healthy volunteers. Data analysis of 571 paired measurements from 29 participants indicates that heart rate measurements via AS were accurate, though they lacked precision, with the clinical agreement range between 6.38 and 6.49 beats per minute. Temperature and oxygen saturation measurements showed less agreement when compared with the reference standard. In conclusion, ambient sensors show promising utility in measuring vital signs, with this study amongst the first of its kind to utilise this in measuring vital signs in hospitalised patient cohorts in both ward and home environments.

To determine the smallest worthwhile effects (SWEs) of supervised individual, supervised group, or unsupervised digitally-delivered strength exercise on pain intensity, compared to no exercise, for individuals with knee osteoarthritis. Online benefit-harm trade-off study. Participants with knee pain consistent with knee osteoarthritis were allocated information about either supervised individual, supervised group, or unsupervised digitally-delivered strength exercise and a no exercise comparison. Participants selected the pain reduction (percentage) that would make their allocated mode of strength exercise worthwhile, in addition to a 15% improvement with no exercise, considering its cost, harms, and inconveniences. SWEs were estimated as the median (95% confidence interval (CI)) and interquartile range (IQR) of the smallest pain reduction that participants considered worthwhile. SWEs were also estimated across participant subgroups (sex, pain severity, and exercise beliefs and history). We included 1,176 participants. Eight to sixteen percent would not consider exercise worthwhile even if it completely resolved their knee pain. The SWE of both supervised individual and group strength exercise was a 20% (95% CI 15-20, IQR 5-30%) knee pain reduction, in addition to the pain reduction expected with no exercise. The SWE of unsupervised digital exercise was a 15% additional pain reduction (95% CI 10-20, IQR 5-25%). SWEs were generally larger among males and those not expecting exercise to be helpful. To consider strength exercise worthwhile, people with knee osteoarthritis require supervised individual or group exercise to provide a 20% reduction in knee pain, and digitally-delivered exercise to provide a 15% reduction, beyond the pain reduction expected without exercising.