Physiotherapy in Your Pocket: Effectiveness of Home Exercises Using an AI-Based Smartphone App for the Postoperative Follow-Up of Hand Injuries – A Randomized, Controlled, Open-Label Study

Abstract

Introduction

Hand injuries can cause considerable functional limitations. Successful surgical treatment requires intensive rehabilitation. However, it is often difficult for patients to obtain timely appointments with a therapist. Several studies have already demonstrated the potential of home exercises. The aim of this study is to investigate the effectiveness of an additional hand therapy app compared to physiotherapy alone.

Methods

This is a prospective, randomized, controlled, open-label study. A total of 112 patients aged 18 to 65 years (MV±SD: 36.9 years±15.5) with metacarpal and finger fractures as well as flexor and extensor tendon injuries participated. The app uses artificial intelligence (AI) and the smartphone’s integrated camera to capture finger movements and determine the range of motion (ROM). Furthermore, the integrated AI automatically adjusts the type and intensity of treatment based on the patient's therapy progress and symptoms. The patients were divided into two groups. The intervention group (IG) received the app Novio Hand for 12 weeks after the immobilization phase in addition to hand therapy (18 units) as standard care (SoC). The control group (CG) received SoC alone. Improvement in ROM was measured at baseline and after 2, 6, and 12 weeks.

Results

Independent t-tests showed significantly greater ROM in the IG compared to the CG at 2 and 6 weeks (p=0.02). A significant trend was observed at 12 weeks. In the IG (50%), significantly more patients achieved the minimal clinically important difference (MCID) of 40 degrees compared to the CG (26%). At 6 weeks, the difference was also significant (IG: 79%, KG: 54%). In the IG, fractures showed an almost full range of motion on average after 6 weeks, whereas in the CG, significant movement deficits could still be quantified after 12 weeks.

Conclusion

Therapy with the Novio Hand app, in addition to SoC can accelerate rehabilitation and improve functional results. The hand therapy app effectively serves as a “physiotherapist” in your pocket, allowing for regular training at any time and from any location.

Keywords

Hand therapy - artificial intelligence (AI) - fracture - flexor tendon injury

Publication History

Received: 30 December 2024

Accepted: 08 April 2025

Article published online:
02 July 2025

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