Assessing the Impact of a Novel Smartphone Application Compared With Standard Follow-Up on Mobility of Patients With Knee Osteoarthritis Following Treatment With Hylan G-F 20: A Randomized Controlled Trial
Open accessAbstract
BACKGROUND: Osteoarthritis (OA) is a leading cause of disability in the United States. Although no disease-modifying therapies exist, patients with knee OA who increase walking may reduce risk of functional limitations. OBJECTIVE: The objective of the study is to evaluate the impact of a mobile app (OA GO) plus wearable activity monitor/pedometer (Jawbone UP 24) used for 90 days on the mobility of patients with knee OA treated with hylan G-F 20. METHODS: were excluded. All patients received a single 6-mL injection of hylan G-F 20 and wore the Jawbone monitor. The patients were then randomized 1:1 to Jawbone and OA GO (Group A; n=107) with visible feedback (unblinded) or Jawbone only (Group B; n=104) with no visible feedback (blinded). The primary endpoint was mean change from baseline in steps per day at day 90 between Groups A and B. RESULTS: Baseline characteristics were similar between groups. There were significant differences between the increases in least squares (LS) mean number of steps per day (1199 vs 467, P=.03) and the mean percentage change (35.8% vs 11.5%, P=.02) from baseline in favor of Group A over Group B. There was a greater reduction in pain from baseline during the 6-minute walk test in Group A versus Group B. (LS mean change: -55.3 vs -33.8, P=.007). Most patients (65.4%) and surveys of physicians (67.3%) reported they would be likely or very likely to use/recommend the devices. Patient Activity Measure-13 scores improved from baseline (LS mean change for Groups A and B: 5.0 vs 6.9), with no significant differences between groups. The occurrence of adverse events was similar in the 2 groups. CONCLUSIONS: Use of a novel smartphone app in conjunction with a wearable activity monitor provided additional improvement on mobility parameters such as steps per day and pain with walking in the 6-minute walk test in patients with knee OA who were treated with hylan G-F 20. Results also highlight the amenability of patients and physicians to using mobile health technology in the treatment of OA and suggest further study is warranted.
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1 study [22] was judged as high risk for other sources of bias because of conflicts of interest declared by the authors.
“and 1 study [22] was judged as high risk for other sources of bias because of conflicts of interest declared by the authors.”
From Consumer-based wearable activity trackers increase physical activity participation: systematic review and meta-analysis (2019) · cites this paper as [22]
The Methods (Study Population and Study Design; page unavailable) identify this as the trial and mention a study sponsor. The high-risk judgment is the citing authors’ own assessment, but our copy does not show the authors’ declared conflicts of interest that the sentence gives as its basis; searches for conflicts, disclosures, and funding did not locate them. (LLM, conf=0.70)
Experimental — accuracy not yet measuredRandomized controlled trials have shown that consumer-based wearable activity trackers have promise in relation to increasing physical activity participation.
“Randomized controlled trials have shown that these devices have promise in relation to increasing physical activity participation [21,22]”
From Consumer-based wearable activity trackers increase physical activity participation: systematic review and meta-analysis (2019) · cites this paper as [22]
The Results > Mobility and Pain section (page unavailable) reports a significantly greater increase in daily steps in the intervention group, supporting the claim that this approach has promise. However, the Methods > Study Design section shows that patients received both a wearable tracker and a smartphone app, while the comparison group also wore a tracker without access to its data. The trial therefore does not establish an effect of consumer wearable trackers alone, and its participants were patients with knee osteoarthritis rather than a general population. (LLM, conf=0.86)
Experimental — accuracy not yet measuredActual wear time of the activity tracker varied, ranging from over 90% wear time to all participants ceasing to wear the device by the end of the intervention.
“Actual wear time of the activity tracker varied, ranging from over 90% wear time [21,22] to all participants ceasing to wear the device by the end of the intervention [32] as the study design allowed self-directed wear of the activity tracker.”
From Consumer-based wearable activity trackers increase physical activity participation: systematic review and meta-analysis (2019) · cites this paper as [22]
The Results section (Patient Disposition, Baseline Characteristics, and Adherence; page unavailable) reports that 91.0% of patients were compliant, defined as wearing the monitor at least 80% of the time. That does not establish over 90% actual wear time. The claim that all participants stopped wearing a device is attached to a different citation, not this paper. (LLM, conf=0.87)
Experimental — accuracy not yet measuredA total of 26 studies were included across all meta-analyses.
“A total of 26 studies were included across all meta-analyses [21,22,29-48,50-53].”
From Consumer-based wearable activity trackers increase physical activity participation: systematic review and meta-analysis (2019) · cites this paper as [22]
17 studies reported activity tracker adherence data, with 13 of these reporting activity tracker wear on at least 50% of the study intervention days.
“Moreover, 17 studies reported activity tracker adherence data [21,22,30,32,34,35, 37,38,40,41,43-45,50-52,54], with 13 of these studies [21,22,30,34,35,40,41,43,44,50-52,54] reporting activity tracker wear on at least 50% of the study intervention days.”
From Consumer-based wearable activity trackers increase physical activity participation: systematic review and meta-analysis (2019) · cites this paper as [22]
3 studies required participants to be proficient at using the internet and/or smartphones.
“with 3 studies requiring participants to be proficient at using the internet and/or smartphones [21,22,45].”
From Consumer-based wearable activity trackers increase physical activity participation: systematic review and meta-analysis (2019) · cites this paper as [22]
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References 51 · Cited by 88
- Authors
- Skrepnik, N., Spitzer, A., Altman, R., Hoekstra, J., Stewart, J., & Toselli, R.
- Affiliations
- Tucson Orthopaedic Institute (US)
- Cedars-Sinai Medical Center (US)
- University of California, Los Angeles (US)
- National Clinical Research (US)
- Sanofi (Canada) (CA)
- Sanofi (France) (FR)
- Corresponding author
- Skrepnik, Nebojsa
- Venue
- JMIR mHealth and uHealth
- Publisher
- JMIR Publications Inc.
- Published
- 2017-05-09
- Volume
- 5
- Issue
- 5
- Pages
- e64
- ISSN
- 2291-5222 (ISSN-L)
- PMC
- PMC5442351
- OpenAlex
- W2612207358
- Cited by
- 88
- References
- 51
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 11 · 2023: 15 · 2022: 17 · 2021: 10 · 2020: 13 · 2019: 4 · 2018: 9
- FWCI
- 10.99
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- JMIR mhealth and uhealth (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Rheumatology › Osteoarthritis Treatment and Mechanisms
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Keywords
- hylan G-F 20, hyaluronic acid injection, mobile health, mobile application, wearable activity trackers, pedometers, physical activity, walking steps, 6-minute walk test, patient activity, technology acceptance, follow-up care
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