Background: Recent technological developments such as wearable sensors and tablets with a mobile internet connection hold promise for providing electronic health home-based programs with remote coaching for patients following total hip arthroplasty. It can be hypothesized that such a home-based rehabilitation program can offer an effective alternative to usual care.Objective: The aim of this study was to determine the effectiveness of a home-based rehabilitation program driven by a tablet app and remote coaching for patients following total hip arthroplasty.Methods: Existing data of two studies were combined, in which patients of a single-arm intervention study were matched with historical controls of an observational study. Patients aged 18-65 years who had undergone total hip arthroplasty as a treatment for primary or secondary osteoarthritis were included. The intervention consisted of a 12-week home-based rehabilitation program with video instructions on a tablet and remote coaching (intervention group). Patients were asked to do strengthening and walking exercises at least 5 days a week. Data of the intervention group were compared with those of patients who received usual care (control group). Effectiveness was measured at four moments (preoperatively, and 4 weeks, 12 weeks, and 6 months postoperatively) by means of functional tests (Timed Up & Go test and the Five Times Sit-to Stand Test) and self-reported questionnaires (Hip disability and Osteoarthritis Outcome Score [HOOS] and Short Form 36 [SF-36]). Each patient of the intervention group was matched with two patients of the control group. Patient characteristics were summarized with descriptive statistics. The 1:2 matching situation was analyzed with a conditional logistic regression. Effect sizes were calculated by Cohen d.Results: Overall, 15 patients of the intervention group were included in this study, and 15 and 12 subjects from the control group were matched to the intervention group, respectively. The intervention group performed functional tests significantly faster at 12 weeks and 6 months postoperatively. The intervention group also scored significantly higher on the subscales "function in sport and recreational activities" and "hip-related quality of life" of HOOS, and on the subscale "physical role limitations" of SF-36 at 12 weeks and 6 months postoperatively. Large effect sizes were found on functional tests at 12 weeks and at 6 months (Cohen d=0.5-1.2), endorsed by effect sizes on the self-reported outcomes.Conclusions: Our results clearly demonstrate larger effects in the intervention group compared to the historical controls. These results imply that a home-based rehabilitation program delivered by means of internet technology after total hip arthroplasty can be more effective than usual care.Keywords: home-based rehabilitation program; internet; osteoarthritis; physiotherapy; rehabilitation; remote coaching; tablet app; total hip arthroplasty; total hip replacement; usual care.
Nowadays, Nature-Based Solutions (NBSs) are developing as innovative multifunctional tools to maximize urban ecosystem services such as storm water preservation, reduction of runoff and flood protection, groundwater pollution prevention, biodiversity enhancement, and microclimate control. Gdańsk is one of the first Polish cities to widely introduce rain gardens (one example of an NBS) in different areas such as parks, city center, main crossroads, and car parks. They involve different technical innovations individually tailored to local architecture, including historic buildings and spaces. Gdańskie Wody, which is responsible for storm water management in the city, adopted a pioneering strategy and started the construction of the first rain garden in 2018. Currently, there are a dozen rain gardens in the city, and this organisation's policy stipulates the construction of NBSs in new housing estates without building rainwater drainage.Various types of rain gardens can be created depending on location characteristics such as geo-hydrology, as well as local conditions and needs. Furthermore, each of them might be equipped with specific technical solutions to improve the rain garden's function – for example, an oil separator or setter can be included to absorb the initial, most polluted runoff. During winter, the large amount of sodium chloride usually used to grit the roads may pose the greatest threat to biodiversity and plants. These installations have been included in a large rain garden in Gdańsk, located in the central reservation of the main streets in the city center.This work presents various technical considerations and their impact on ecosystem functions, and the urban circularity challenges provided by rain gardens operating in different technologies and surroundings. The precipitation quantity and the following infiltration rate were estimated by installing pressure transducers. Furthermore, mitigation of the urban heat island was analysed based on remote sensing images.
This study investigates the mediating role of organizational citizenship behaviours (OCBs) on the leader-member exchange (LMX) and employee performance relation and the degree to which work experience moderates the relation between leader-member exchange and OCBs. Lecturers from six technical universities in Ghana, making up three hundred and thirty-six lecturers, were selected using convenience sampling. The participants completed self-administered surveys. OCBs fully mediated the association between LMX and employee performance. Furthermore, the findings indicate that the interplay between LMX and work experience on OCBs is compensatory in nature such that as work experience increases, the positive association between LMX and OCBs decrease. Managers of higher education institutions should create enabling work environments that encourage high-quality LMX and citizenship behaviours. Moreover, as work experience tends to attenuate the positive influence of LMX on OCBs, managers in higher education should focus their attention on employees with low rather than high work experience. This research adds to the employee performance literature through examining a novel link among leader-member exchange, organizational citizenship behaviours and performance.
