Is there a role for rehabilitation streaming following total knee arthroplasty? Preliminary insights from a randomized controlled trial
Justine M. Naylor, Jack Crosbie, Victoria Ko
Orthoapedic, Liverpool Hospital, 1871 Sydney, Australia. E-mail: email@example.com
Objective: To determine whether total knee arthroplasty recipients demonstrating comparatively poor mobility at entry to rehabilitation and who received supervised therapy, had better rehabilitation outcomes than those who received less supervision.
Design: Retrospective analysis of randomized trial data.
Patients: Total knee arthroplasty participants randomized to supervised (n = 159) or home-based therapy (n = 74).
Methods: Participants were dichotomized based on mean target 6-min walk test (6MWT) pre-therapy (second post-surgical week). Absolute and change in 6MWT and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain and Function subscales amongst low performers in the supervised (n = 89) and unsupervised (n = 36) groups were compared, as were high performers in the supervised (n = 70) and unsupervised (n = 38) groups.
Results: Low performers in the unsupervised compared with the supervised group demonstrated significantly poorer 6MWT scores (absolute δ = 8.5%, p = 0.003; change δ = 8.1%, p = 0.007) when therapy ceased (10 weeks post-surgery). No differences in 6MWT were observed between the high performing subgroups or in the recovery of WOMAC subscales between any subgroups.
Conclusion: Individuals manifesting comparatively poor mobility at the commencement of physiotherapy may recover their mobility, but not perceived function, more quickly if streamed to supervised therapy.
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