Interactive app based injury prevention programs - same compliance but more effective?

E-health has the potential to facilitate implementation of effective measures to prevent sports injuries. This article form the study of Miriam van Reijen evaluated whether an interactive mobile application containing a proven effective exercise programme to prevent recurrent ankle sprains resulted in higher compliance as compared with regular written exercise materials.

A total of 220 athletes participated in this randomised controlled trial with a follow-up of 8 weeks; 110 athletes received a booklet explaining an 8-week neuromuscular training programme; 110 athletes participated in the same programme in an interactive mobile App (Strengthen your ankle). The primary outcome was compliance with the exercise programme. Secondary outcome measure was the incidence density of self-reported recurrent ankle sprains during the period of the exercise program.

An English version of the Ankle app containing the preventive program is freely available for iOS and Android.

The mean compliance to the exercise scheme was 73.3% (95% CI 67.7% to 78.1%) in the App group, compared with 76.7% (95% CI 71.9% to 82.3%) in the Booklet group. No significant difference in compliance was found between groups. Although the incidence densities of self-reported time-loss recurrences was not significantly higher in the Booklet group (HR 3.07; 95% CI 0.62 to 15.20), the high hazard ratio does show a potential for more preventive effectiveness in the App group. 

  Mean weekly compliance rates and corresponding 95% CI of both groups across the 8 weeks of the neuromuscular training programme. 

Mean weekly compliance rates and corresponding 95% CI of both groups across the 8 weeks of the neuromuscular training programme. 

As such, this study showed that the method of implementing effective exercises by using an App or a Booklet does not lead to different compliance rates. However, there is the potential that through interactive visuals and explanations in an App exercises are conducted better which may lead to better preventive outcomes. Further follow-up may prove this assumption over a longer term. To be continued ....

Van Reijen M, Vriend I, Zuidema V, Mechelen WV, Verhagen E. Increasing compliance with neuromuscular training to prevent ankle sprain in sport: does the “Strengthen your ankle” mobile App make a difference? A randomised controlled trial. Br J Sports Med. 2016 Online First doi: 10.1136/bjsports-2015-095290

The full article can be found here