New PhD: Can a training app relieve physiotherapists?
More and more people are getting osteoarthritis, but many have to wait a long time for physiotherapy. Could a training app be a good alternative?
In the photo: The doctoral student flanked by his supervisors. From left, Tuva Moseng, Nina Østerås, Lars Martinsen and Anne-Therese Tveter
Osteoarthritis of the hip and knee can make it difficult to walk. Exercise can relieve pain and prevent surgery.
The disease affects at least half of us as we age. With an aging population, more and more people need treatment for the disease.
At the same time, the wait time to receive treatment from a physiotherapist can be long. Physiotherapist Lars Martinsen has completed his PhD on whether digital solutions can make treatment for osteoarthritis more accessible.
App or physiotherapist
The researchers compared a training app with regular follow-up with a physiotherapist.
– We wanted to find out if an app could be a real alternative in the treatment of osteoarthritis, not just an addition, says physiotherapist Lars Martinsen (PhD).
His thesis consists of three studies. One compared training via app with regular follow-up with a physiotherapist, for hip and knee osteoarthritis. The second investigated whether the patients actually performed the training. In the third, Martinsen investigated what physiotherapists themselves think about the use of such digital tools.
The study involved 68 people with hip or knee osteoarthritis. They were randomly divided into two groups. All were examined by a physiotherapist.
The group that received standard treatment received guided exercise that was adapted to the individual. The exercises were adjusted along the way and followed up by a physiotherapist in the clinic.
The second group received an individually tailored exercise program in an app. The exercises were adjusted based on pain and performance, which the patients themselves recorded in the app.
After six weeks, there was less pain and better function in both groups.
But the researchers could not determine that app treatment was as good as usual follow-up.
– The results are too uncertain for us to say that the app works as well as follow-up with a physiotherapist, says Martinsen.
App did not provide better performance
Many people think that an app will make it easier to follow the exercise program. The study showed otherwise. The patients who used the app did not follow the exercise program better than those who were followed up by a physiotherapist.
Martinsen says that other factors also affected the exercise in both groups. Patients who were less exhausted, had higher education and greater belief that they could manage the disease completed more exercise sessions.
“Technology alone doesn't solve everything. We need to understand the patients' everyday lives and what resources they have,” says Martinsen.
Positive physiotherapists – but clear challenges
The researcher also investigated what physiotherapists thought about using digital tools in their clinical practice. Around half were already using digital tools in their treatment. Eight out of ten were positive about recommending the technology to their patients.
At the same time, the physiotherapists pointed out several challenges.
They believed that a physical examination is still important. It can make it easier to detect serious illness and build trust between patient and practitioner.
Several also called for more training and better technical support to become more confident in using digital solutions.
Part of the future healthcare service
Martinsen believes that digital solutions can become an important part of the future healthcare service.
“Technology can make treatment more accessible. But it cannot replace the physiotherapist alone,” he says.
The research shows both the possibilities and limitations of digital follow-up.
– Good treatment is still about more than technology alone.
Martinsen believes that more research is needed to find out which patients benefit most from such solutions.
Fact
Doctorate
Lars Martinsen defended his doctorate at Diakonhjemmet Hospital on March 26, 2026.
Sample lecture
DIGITAL 'DIVINE' OR DIGITAL DIVIDE IN HEALTHCARE
Topic:
Digital solutions in the treatment of musculoskeletal disorders and osteoarthritis in primary health care.
Dissertation
Digital health technologies in the management of musculoskeletal disorders and osteoarthritis in primary physiotherapy care.
INSTITUTION
University of Oslo, Faculty of Medicine, Department of Health and Society. The doctoral work was carried out at Diakonhjemmet Hospital.
FUNDING
The Dam Foundation
SUPERVISORS
Anne Therese Tveter, Nina Østerås and Tuva Moseng
ASSESSMENT COMMITTEE
Søren Thorgaard Schou, Helen French and Lise Solberg Nes
DISSERTATION SUPERVISOR
Trygve Skonnord
Publications from the doctoral work
Comparative study (Randomized controlled trial)
Compared training via an app with regular follow-up with a physiotherapist for 68 people with osteoarthritis of the hip and/or knee. They were randomly assigned to one or the other group .
Study of exercise adherence.
Examined whether patients followed the exercise program better via app or with follow-up with a physiotherapist.
Survey among physiotherapists in primary health care
to map the use of and attitudes towards digital health technology in the treatment of musculoskeletal disorders.
Scientific publications
App-based exercise intervention versus supervised exercise therapy for patients with hip or knee osteoarthritis – the randomized non-inferiority DigiOA trial.
