Does Activity-Based Rehabilitation With Goal Attainment Scaling Increase Physical Activity Among Younger Knee Arthroplasty Patients? Results From the Randomized Controlled ACTION Trial

Hoorntje, Alexander; Witjes, Suzanne; Kuijer, Paul; Bussmann, Johannes B. J.; Horemans, Herwin; Kerkhoffs, Gino M. M. J.; Geenen, Rutger C. I. van; Koenraadt, Koen L. M.

doi:10.1016/j.arth.2019.10.028

Cited by 19 publications

(58 citation statements)

References 33 publications

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“…Physical activity was objectively measured preoperatively and 6 months postoperatively using a 3-dimensional (3D) accelerometer. The physical activity data were published previously 29 .…”

Section: Methodsmentioning

confidence: 99%

Goal Attainment Scaling Rehabilitation Improves Satisfaction with Work Activities for Younger Working Patients After Knee Arthroplasty

Hoorntje

Waterval-Witjes

Koenraadt

et al. 2020

Journal of Bone and Joint Surgery

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Background: Knee arthroplasty (KA) is increasingly performed in relatively young, active patients. This heterogeneous patient population often has high expectations, including work resumption and performance of knee-demanding leisure-time activities. Goal attainment scaling (GAS) may personalize rehabilitation by using patient-specific, activity-oriented rehabilitation goals. Since unmet expectations are a leading cause of dissatisfaction after KA, personalized rehabilitation may improve patient satisfaction. We hypothesized that, compared with standard rehabilitation, GAS-based rehabilitation would result in younger, active patients having higher satisfaction regarding activities after KA. Methods: We performed a single-center randomized controlled trial. Eligible patients were <65 years of age, working outside the home, and scheduled to undergo unicompartmental or total KA. The required sample size was 120 patients. Using GAS, patients developed personal activity goals with a physiotherapist preoperatively. These goals were used to monitor patients’ goal attainment and provide goal-specific feedback during postoperative outpatient rehabilitation. Standard rehabilitation consisted of regular outpatient physiotherapy visits. The primary outcome measures were visual analogue scale (VAS) scores (scale of 0 to 100) for satisfaction regarding activities of daily living and work and leisure-time activities 1 year postoperatively, which were analyzed using generalized estimating equation models. Results: Patient satisfaction with work activities was significantly higher in the GAS group (β = 10.7 points, 98% confidence interval [CI] = 2.0 to 19.4 points) than in the control group. Patient satisfaction with activities of daily living and leisure-time activities did not differ between groups. We found no differences in VAS satisfaction scores between unicompartmental KA and total KA. Conclusions: Personalized, goal-specific rehabilitation using GAS resulted in higher patient satisfaction with work activities, compared with standard rehabilitation, 1 year after KA. Level of Evidence: Therapeutic Level I . See Instructions for Authors for a complete description of levels of evidence.

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“…Physical activity was objectively measured preoperatively and 6 months postoperatively using a 3-dimensional (3D) accelerometer. The physical activity data were published previously 29 .…”

Section: Methodsmentioning

confidence: 99%

Goal Attainment Scaling Rehabilitation Improves Satisfaction with Work Activities for Younger Working Patients After Knee Arthroplasty

Hoorntje

Waterval-Witjes

Koenraadt

et al. 2020

Journal of Bone and Joint Surgery

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“…See flow diagram in Figure 1. which were delivered over 12, 12, 6, 24 and 24 week periods respectively (29)(30)(31)(32)(33) .…”

Section: Study Selectionmentioning

confidence: 99%

Physical Activity Interventions After Hip or Knee Joint Replacement: a Systematic Review

Ishaku

Min

Hall

2020

Curr Phys Med Rehabil Rep

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Background Studies show that following lower-limb joint replacement surgery most patients fail to achieve the recommended amount of physical activity. This study aims to describe and evaluate physical activity interventions in individuals that have undergone hip or knee joint replacement due to osteoarthritis. Design A systematic review. Protocol registration PROSPERO CRD42016033498 (http://www.crd.york.ac.uk/PROSPERO/). Experimental and observational study designs investigating physical activity interventions after joint replacement were considered. The primary outcome was self-reported or objectively measured change in physical activity. Two reviewers extracted the data and appraised the methodological quality of the included studies. Results 11873 studies were screened. Seven studies with 627 participants, aged 50 to 85 years met the review criteria. Five randomised control trial, one longitudinal quasi-experimental study with a control group and one pre/post-test study with control group. Interventions included health coaching, a walking programme, a behavioural change intervention and an alpine skiing intervention delivered between 6 and 24 weeks.Two studies reported change in physical activity using patient activity diaries and five used objective accelerometer data. Statistical pooling of the study results was not possible. However, all studies showed an increase in time spent being physically active in the intervention groups. One study also reported an increase in vitality.Conclusions Few studies have investigated physical activity interventions after hip or knee joint replacement, and evidence for the effectiveness of physical activity interventions post-replacement is low. High quality studies are needed in this area to explore the potential benefits presented within this review.

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“…11 A more recently published study showed that an intervention in which patients worked towards self-chosen activity goals together with a physical therapist lead to statistically significant more physical activity than with usual care, although only 9 min/day. 12 These interventions may be promising. However, a limiting factor in the implementation of these interventions may be the finite amount of time a healthcare professional can spend on each patient.…”

Section: The Importance Of Physical Activity and Other Forms Of Societal Participationmentioning

confidence: 99%

Knee arthroplasty: a window of opportunity to improve physical activity in daily life, sports and work

Coenen

Straat

Kuijer

2020

BMJ Open Sport Exerc Med

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Does Activity-Based Rehabilitation With Goal Attainment Scaling Increase Physical Activity Among Younger Knee Arthroplasty Patients? Results From the Randomized Controlled ACTION Trial

Cited by 19 publications

References 33 publications

Goal Attainment Scaling Rehabilitation Improves Satisfaction with Work Activities for Younger Working Patients After Knee Arthroplasty

Goal Attainment Scaling Rehabilitation Improves Satisfaction with Work Activities for Younger Working Patients After Knee Arthroplasty

Physical Activity Interventions After Hip or Knee Joint Replacement: a Systematic Review

Knee arthroplasty: a window of opportunity to improve physical activity in daily life, sports and work

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