Ergometer Cycling After Hip or Knee Replacement Surgery

Background Specific anatomic differences are believed to account for gender-specific function and health-related quality of life after TKA. However, there are conflicting data in the literature regarding these gender-specific outcomes, especially as woman appear to have surgery later in the course of the disease compared with men. Questions/purposes We asked whether (1) women had worse knee function and health-related quality of life after TKA compared with men, (2) lower improvements in scores, and (3) slower recovery after surgery. Methods Using a cohort study design, we retrospectively analyzed prospectively collected data from three multicenter randomized controlled trials evaluating rehabilitation measures after standard unisex knee arthroplasty in 494 patients (141 men and 353 women). The primary outcome was selfreported physical function as measured by the WOMAC at 3, 6, 12, and 24 months after surgery. Secondary outcomes included the pain and stiffness scales of the WOMAC and the physical and mental component summaries of the SF-36. At the time of surgery, the women were on average older (70.8 versus 67.8 years), had lower mean physical function (55 versus 47), higher mean pain scores (54 versus 48), and greater stiffness (54 versus 46) as measured by the WOMAC. Results At the 3-, 6-, 12-, and 24-month followups, men and women had similar WOMAC scores. Improvements were greater for women compared with men for WOMAC 123Clin Orthop Relat Res (2011) 469:2855-2865 DOI 10.1007/s11999-011-1921 function and pain subscale scores at the 3-month (function, 28 versus 23; pain, 32 versus 25) and 6-month followups (function, 32 versus 27; pain, 36 versus 31). At the 12-and 24-month followups we noted no differences in improvement between men and women. Conclusion Although women had greater functional limitations at the time of surgery than men, they recover faster early after standard TKA although function is similar at 12 and 24 months. Women also had greater improvement of WOMAC scores after standard TKA than men. Level of Evidence Level II, prognostic study. See the guidelines for authors for a complete description of levels of evidence.

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“…Data from 362 of those patients suggested ergometer cycling enhanced rehabilitation after THA, but not after TKA [17].…”

Section: Methodsmentioning

confidence: 99%

Women Recover Faster Than Men after Standard Knee Arthroplasty

Liebs¹,

Herzberg

Roth-Kroeger

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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“…The focus of the intervention was movement and exercise, 591,596,601 exercises aimed at managing kinesiophobia, 598 functional 588,597 or strengthening exercise 514 compared with minimal physiotherapy exercise as discussed in seven studies; home compared with outpatient provision as discussed in six studies; 520,592,594,595,602 physiotherapy with additional balance 589,600 or cycling components 593 compared with standard physiotherapy as discussed in three studies; and pool-based compared with gym-based provision as discussed in one study. …”

Section: Intervention Focusmentioning

confidence: 99%

Improving patients’ experience and outcome of total joint replacement: the RESTORE programme

Blom

Artz

Beswick

et al. 2016

Programme Grants Appl Res

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General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Full terms of use are available: http://www.bristol.ac.uk/pure/about/ebr-terms PROGRAMME GRANTS FOR APPLIED RESEARCH VOLUME 4 ISSUE 12 AUGUST 2016 ISSN 2050 DOI 10.3310/pgfar04120Improving patients' experience and outcome of total joint replacement: the RESTORE programme Ashley W Blom, Neil Artz, Andrew D Beswick, Amanda Burston, Paul Dieppe, Karen T Elvers, Rachael Gooberman-Hill, Jeremy Horwood, Paul Jepson, Emma Johnson, Erik Lenguerrand, Elsa Marques, Sian Noble, Mark Pyke, Catherine Sackley, Gina Sands, Adrian Sayers, Victoria Wells and Vikki Wylde Improving patients' experience and outcome of total joint replacement: the RESTORE programme ISSN 2050-4330 (Online) This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: nihredit@southampton.ac.ukThe full PGfAR archive is freely available to view online at www.journalslibrary.nihr.ac.uk/pgfar. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Programme Grants for Applied Research journalReports are published in Programme Grants for Applied Research (PGfAR) if (1) they have resulted from work for the PGfAR programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors. Programme Grants for Applied Research programmeThe Programme Grants for Applied Research (PGfAR) programme, part of the National Institute for Health Research (NIHR), was set up in 2006 to produce independent research findings that will have practical application for the benefit of patients and the NHS in the relatively near future. The Programme is managed by the NIHR Central Commissioning Facility (CCF) with strategic input from the Programme Director.The programme is a national response mode funding scheme that aims to provide evidence to improve health outcomes in England through promotion of health, prevention of ill health, and optimal disease management (including safety and quality), with particular emphasis on conditions causing significant disease burden.For more information about the PGfAR programme please visit the website: http://www.nihr.ac.uk/funding/programme-grants-forapplied-research.htm This reportThe research reported in this issue of the journal was funded by PGfAR as project number RP-PG-0407-10070. The contractual start date was in December 2008. The final report began editorial review in September 2014 and was accepted for publication in August 2015. As the funder, the PGfAR programme agreed the research questions and study designs in advance with the investigators. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The PGfAR editors and production house have tried to ensure the accurac...

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“…A multi center RCT, to evaluate whether the timing of aquatic therapy affected clinical outcomes after TKA, showed that all the primary outcomes (as assessed by the WOMAC scale) were better in the early aquatic therapy group [42]. Hydrotherapy positively influenced mood and socialisation, and promoted social relationships such as friendship and feelings of well-being.…”

Section: Hydrotherapymentioning

confidence: 99%

“…The problems connected with hydrotherapy are cost and organisation. Hydrotherapy seems to be a better treatment than land-kinesis, because pain, stiffness and function impairment emerged as significantly lower and it had a positive influence on social behaviour and mood [40][41][42][43][44].…”

Section: Hydrotherapymentioning

confidence: 99%

Rehabilitation and Physical Therapy before and after Total Knee Arthroplasty: A Literature Review and Unanswered Questions

Aless¹,

Bistolfi²,

Federico³

et al. 2016

Int J Phys Med Rehabil

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This review focuses on the validity and the effectiveness of rehabilitation techniques and physical therapies before and after total knee arthroplasty (TKA). The intent is to drive surgeons and rehabilitation specialists in the choice of the strategies for the treatment after TKA. The Data sources were MEDLINE, PubMed, CINAHL, EMBASE, and PsychINFO databases using the selected key words. Three authors independently selected studies for review using as criteria English, adults, any clinical population, and intervention for. Among several published studies of rehabilitation after TKA, only a few were based on scientific evidence. Moreover, many studies were heterogeneous and included different outcomes and evaluations. There is consensus that a complete and specific rehabilitation post-operative programme is effective in reducing the length of hospitalisation and the incidence of early complications. However, it is not clear what "complete and specific rehabilitation" may mean: the real efficacy of every specific treatment (continuous passive motion, cryotherapy, magneto therapy, neuro muscular electrical stimulation, whole body vibration, hydrotherapy, pre-operative physiotherapy) is still questionable, and often related to the experience of the authors. In conclusion, patients undergoing physiotherapy obtain a better and faster outcome achievement than non-treated patients; however, evidence-based treatments, protocols and clinical trials are recommended.

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Ergometer Cycling After Hip or Knee Replacement Surgery

Cited by 77 publications

References 18 publications

Women Recover Faster Than Men after Standard Knee Arthroplasty

Women Recover Faster Than Men after Standard Knee Arthroplasty

Improving patients’ experience and outcome of total joint replacement: the RESTORE programme

Rehabilitation and Physical Therapy before and after Total Knee Arthroplasty: A Literature Review and Unanswered Questions

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