Intelligent wearable-enhanced WeChat platform with multidisciplinary tele-rehabilitation reduces caregiver burden and psychological distress in congenital pseudarthrosis of the tibia: a randomized controlled trial

Background: Congenital pseudarthrosis of the tibia (CPT) is a rare and refractory congenital malformation with a prolonged and complex treatment course, imposing substantial caregiving burdens and psychological distress on the parents of affected children. Conventional postoperative management, limited by time and space, fails to provide individualized and dynamic rehabilitation and psychological support. Remote management via a smart wearable-enhanced WeChat platform offers a promising alternative. This study aimed to evaluate the effects of this remote management approach on the mental health, sleep, and overall well-being of parents of children with CPT. Methods: A double-blind randomized controlled design was adopted in this study. A total of 78 primary caregivers of 78 CPT patients were assigned to the standard education and care (SEC) group (n=39) and the WeChat-platform intelligent management (WPIM) group (n=39) using block randomization. Both groups received standard peri-operative education and outpatient follow-up after discharge. The WPIM group additionally implemented an intelligent intervention system based on the WeChat platform: (I) real-time monitoring of postoperative rehabilitation exercise data through smartwatches (Huawei GT3), including biomechanical parameters such as daily gait characteristics, weight-bearing time, activity intensity, and heart rate variability; (II) establishment of personalized exercise prescriptions based on machine-learning algorithms, with automatic warnings triggered when the monitored data deviated from the preset rehabilitation trajectory; (III) formation of a multidisciplinary team (orthopedic surgeons, rehabilitation therapists, and psychologists) for online guidance twice a week, and dynamic adjustment of the training program in combination with the data from wearable devices; (IV) development of a dedicated WeChat mini-program for visual tracking of exercise compliance, and embedding of a cognitive-behavioral therapy module to improve the psychological adaptation of parents. The Family Caregiver Task Inventory (FCTI), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and Pittsburgh Sleep Quality Index (PSQI) were used for evaluation. Results: There were no statistically significant differences in the demographic characteristics of the caregivers of CPT patients between the two groups. After the intervention, the FCTI, SAS, SDS, and PSQI scores of the caregivers in the WPIM group were significantly lower than those in the SEC group (P