Smart phone-based application for evaluation and rehabilitation of hindfoot pain

Hindfoot pain (HP) affects the population ranges from 4 to 20 percent, and over half of these report disabling pain. The primary aim of our study was to investigate the implementation exercises programmes of the developed web-based smartphone enabled tele-rehabilitation systems compared to the home-based telerehabilitation and conventional physiotherapy approaches. Secondary was to develop analysis systems that can be remotely evaluate ankle ROM and foot deformity with smartphone applications (DijiA & Ardayak) and to investigate its reliability with the universal goniometer (UG) and the SIDAS Analysis machine respectively. According to our aims, I) hindfoot pain patients ( N=77 with 120 feet), II) smartphone applications pilot tests volunteers; a) healthy university students (N=22 with 44 feet) for ROM- DF and PF measurement (DijiA), b) patients with foot deformity (N=14 with 28 feet) for detection of the foot deformity (ArdAyak) were admitted in this study. HP patients were randomised into three different rehabilitation programmes a) conventional physiotherapy, b) home-based rehabilitation, and c) tele-rehabilitation programs. The outcomes of HP patients' pain, disability, function and kinesiophobia were assessed at pre-post intervention (8th week). The reliability of DijiA in ankle joint dorsiflexion and plantarflexion ROM measurement compared with universal goniometer (UG) ROM and ArdAyak foot deformity detection analysis compared with SİDAS Custom Analysis device were tested. Conventional physiotherapy for PFs had significant improvement in functional capacity statistically than others (p<.05). Tele-rehabilitation for both pathologies had more significant improvement than the others in terms of kinesiophobia (p<.05). Pearson correlation test showed a moderate positive correlation between the DijiA-UG (r=.323 for DF, r=.435 for PF, p<.05). The variation in Pearson Correlation Coefficient was showed a moderate positive relationship with r values of 0.468 for foot deformity (p<.05). Conventional physiotherapy program can be recommended for the management of HP. Telerehabilitation may be a more convenient way to apply exercises programmes for kinesiophobia. The promising DijiA & Ardayak apps have the potential to be a appropriate and easy-to-use tool for the assessment of ankle ROM and foot deformity.