Effectiveness of Continuous Passive Motion in an Inpatient Rehabilitation Hospital After Total Knee Replacement: A Matched Cohort Study

Herbold, Janet; Bonistall, Kristen; Blackburn, Marielle

doi:10.1016/j.pmrj.2012.07.004

Cited by 10 publications

(5 citation statements)

References 20 publications

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“…Some of the included studies reported the clinical effectiveness of physiotherapy interventions on knee flexion ROM only and knee extension ROM only. Data on knee flexion ROM were available in five studies with 366 patients [ 23 , 27 , 28 , 42 , 43 ]. The meta-analysis of the three studies [ 23 , 42 , 43 ] indicated that patients that received physiotherapy interventions favoured the treatment group at 3 or 4 weeks, SMD − 0.055 [95% CI − 0.450 to 0.341] (Fig.…”

Section: Resultsmentioning

confidence: 99%

Clinical and cost-effectiveness of physiotherapy interventions following total knee replacement: a systematic review and meta-analysis

Fatoye

Yeowell

Wright

2021

Arch Orthop Trauma Surg

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Purpose Osteoarthritis is the single most common cause of pain and disability in older adults. This review addresses the question of the clinical effectiveness and cost-effectiveness of physiotherapy interventions following total knee replacement (TKR). Methods A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. MEDLINE, CINAHL, AMED, DARE, HTA and NHS EED databases were searched from inception to 02 May 2020. Search terms related to the clinical and cost-effectiveness of physiotherapy interventions were used. Studies meeting the inclusion criteria were identified and key data were extracted. Random effect meta-analysis was conducted for pain, physical function and range of motion (ROM). Results In total, 1467 studies were identified. Of these, 26 studies were included; methodological quality of most studies was adequate. Physiotherapy interventions were more effective than control for function, SMD − 0.166 [95% Confidence Interval (CI) − 0.420 to 0.088.] and ROM, SMD − 0.219 [95% CI − 0.465 to 0.028] for a follow-up of 2 or 3 months. Patients in the intervention group showed improvement in pain at 12–13 weeks, SMD − 0.175 [95% CI − 0.416 to 0.067]. No evidence on the pooled estimate of cost-effectiveness of physiotherapy interventions was found. Conclusions This is the first systematic review and meta-analysis that has examined the clinical and cost-effectiveness of physiotherapy interventions following TKR. The findings of this review suggest that physiotherapy interventions were effective for improving physical function, ROM and pain in a short-term follow-up following TKR. Insufficient evidence exists to establish the benefit of physiotherapy in the long term for patient with TKR. Further study should examine the long-term effectiveness and cost-effectiveness of physiotherapy interventions.

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Section: Resultsmentioning

confidence: 99%

Clinical and cost-effectiveness of physiotherapy interventions following total knee replacement: a systematic review and meta-analysis

Fatoye

Yeowell

Wright

2021

Arch Orthop Trauma Surg

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“…CPM use in post acute rehabilitation, such as within homecare services or in an inpatient rehabilitation facility setting, does not appear to offer long term benefits following unilateral TKR, regardless of initial range of motion [16][17][18]. Our study further explored its use by applying it to only patients with active maximum knee flexion range of motion between 45°-75° which identified patients most at risk for stiffness.…”

Section: Discussionmentioning

confidence: 99%

“Is Continuous Passive Motion Beneficial for Early Post Operative Period in TKA Patients?”

Shah¹

2018

BJSTR

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“…[6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] Eleven studies were not included, mainly due to incomplete data reporting. [23][24][25][26][27][28][29][30][31][32][33][34] Of the excluded studies, some did not report standard deviations, others did not use a standard protocol for the measurement of range of motion (ROM), and one was outside the date range specified in the inclusion criteria.…”

Section: Discussionmentioning

confidence: 99%

“…11,15,23,31,57 However, more recent studies seem to refute these findings, claiming no benefit in CPM after TKA. [6][7][8][18][19][20]28,29,[32][33][34]58 In an attempt to make sense of the conflicting evidence, several systematic reviews have been conducted. However, these reviews have had conflicting conclusions as well.…”

Section: Short-term Postoperative Interventionsmentioning

confidence: 99%

Perioperative Physiotherapy in Total Knee Arthroplasty

Joice¹,

Bhowmick²,

Amanatullah³

2017

Orthopedics

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Total knee arthroplasty has a high success rate. In the interest of enhancing patient outcomes, numerous perioperative interventions have been studied, including preoperative education, preoperative rehabilitation, postoperative inpatient rehabilitation, continuous passive motion, postoperative outpatient rehabilitation, unsupervised in-home exercises, telerehabilitation, and various combinations of these. This comprehensive review analyzes the existing body of evidence on these perioperative interventions and examines some burgeoning opportunities in rehabilitation after total knee arthroplasty in the interest of improving patient outcomes and ensuring sustainable health care utilization for the future of total knee arthroplasty. [Orthopedics. 2017; 40(5):e765-e773.].

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Effectiveness of Continuous Passive Motion in an Inpatient Rehabilitation Hospital After Total Knee Replacement: A Matched Cohort Study

Abstract: For this population, we determined at one facility that less than 30% are provided with a CPM as an adjunct to physical therapy. Using a matched cohort design, we compared CPM use with non-CPM use and determined that the application of CPM may not significantly influence ROM gain.

Cited by 10 publications

References 20 publications

Clinical and cost-effectiveness of physiotherapy interventions following total knee replacement: a systematic review and meta-analysis

Clinical and cost-effectiveness of physiotherapy interventions following total knee replacement: a systematic review and meta-analysis

“Is Continuous Passive Motion Beneficial for Early Post Operative Period in TKA Patients?”

Perioperative Physiotherapy in Total Knee Arthroplasty

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