To stay strong, patients should do some strength training at least twice a week. However arthritic pain can limit walking and activity. The wait for knee surgery can be long, which can lead to loss of muscle strength. Patients who need a new knee joint tend to be older. If older people do not exercise and become weak, they tire easily, and may take longer to recover after surgery. Patients recover faster after having a new knee joint if their leg muscles are strong. This is why exercise before surgery can help people to make the most of their new joint. Patients come to a joint school where the investigators show them exercises and advise how to get ready for surgery. Patients are given a sheet of pictures and prompts for each exercise but the investigators know that some people don't do the exercises that they are given. Exercises are more likely to be done if they are fun, if people can see they make a difference, if they know what to do, and if their physiotherapist can check what they are doing.
Adults aged ≥18 years.
Referred to Hull University Teaching Hospitals NHS Trust t for Knee Arthroplasty at either Castle Hill Hospital or Goole District Hospital and has access to pre operative resources offered by the joint school physiotherapists.
Has access to a device which is compatible with the operational requirements of the Kemtai programme.
Able to give informed consent.
Patients already involved in an exercise or rehabilitation study will be excluded from this study.
Unwilling or unable to consent or complete study measures.
Has insufficient understanding of English or the languages that are supported by the Kemtai programme and does not have someone who can translate.
Is a prisoner
Parallel
Kemtai Digital App
DeviceThis group will be granted access to the Kemtai digital App (the experimental device intervention) which provides an identical exercise prescription to the comparator intervention but supports the patient through the exercise with tracking and real time (mediated via AI) advice on corrective exercise techniques.
NHS standard care
BehavioralThis group will be provided the NHS standard of care which is a paper based handout illustrating the exercises and the prescription to be done before and after surgery.
Length of stay in hospital
Number of hours between time of surgery and time of discharge
Number of post operative physiotherapy contacts
This measure is a count of the number of times that the participant has a documented contact with a physiotherapist after surgery. This may be in person or via telephone or video call, and may take place in hospital or after discharge from hospital after surgery.
Oxford knee scale
The Oxford Knee Score (OKS) is a validated 12-question patient survey used to assess pain and functional limitations in patients with knee arthritis. Scores range from 0-48, with lower score indicating more pain and functional limitations.
EQ5DL- a health-related quality of life tool.
The EQ5DL is a well validated quality of life measure. The scoring is 1-5 across each domain (mobility, self-care, usual activities, pain/discomfort and anxiety/depression) with a higher number indicating worse quality of life in each domain. Scoring: Results in a 5-digit code (e.g., 11111 for excellent quality of life and 5,5,5,5,5 for the worst quality of life
Visual analogue scale
Includes a visual analogue scale (0-100) for patients to rate their health "today". A higher score is indicates better health.
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