Inpatient rehabilitation did not positively affect 6‐month patient‐reported outcomes after hip or knee arthroplasty

Hutchinson, Adam G.; Gooden, Benjamin; Lyons, Matthew; Roe, Justin; O’Sullivan, Michael E.; Salmon, Lucy J.; Martina, Kaka; Pinczewski, Leo A.

doi:10.1111/ans.14814

Cited by 8 publications

(6 citation statements)

References 17 publications

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“…In other words, the more intensely supervised facility-based programs i.e., inpatient or clinic-based programs, do not provide superior recovery to that seen in domiciliary or other forms of home program after unilateral TKA [30–40] or THA [39, 41–45] for uncomplicated patients. The randomized trial evidence is corroborated by several prospective and retrospective observational studies [12, 13, 23, 46–49]. We also know that the more intensely supervised facility-based programs including inpatient rehabilitation are delivered at far greater cost than programs not including inpatient rehabilitation [12, 13, 45] and may not be cost-effective [39, 50].…”

Section: Introductionmentioning

confidence: 93%

Variation in rehabilitation setting after uncomplicated total knee or hip arthroplasty: a call for evidence-based guidelines

Naylor

Hart²,

Harris

et al. 2019

BMC Musculoskelet Disord

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Background High-level evidence consistently indicates that resource-intensive facility-based rehabilitation does not provide better recovery compared to home programs for uncomplicated knee or hip arthroplasty patients and, therefore, could be reserved for those most impaired. This study aimed to determine if rehabilitation setting aligns with evidence regardless of insurance status. Methods Sub-study within a national, prospective study involving 19 Australian high-volume public and private arthroplasty centres. Individuals undergoing primary arthroplasty for osteoarthritis participated. The main outcome was the proportion participating in each rehabilitation setting, obtained via chart review and participant telephone follow-up at 35 and 90 days post-surgery, categorised as ‘facility-based’ (inpatient rehabilitation and/or ≥ four outpatient-based sessions, including day-hospital) or ‘home-based’ (domiciliary, monitored or unmonitored home program only). We compared characteristics of the study cohort and rehabilitation setting by insurance status (public or private) using parametric and non-parametric tests, analysing the knee and hip cohorts separately. Results After excluding ineligible participants (bilateral surgeries, self-funded insurance, participation in a concurrent rehabilitation trial, experience of a major acute complication potentially affecting their rehabilitation pathway), 1334 eligible participants remained. Complete data were available for 1302 (97%) [Knee: n = 610, mean age 68.7 (8.5) yr., 51.1% female; Hip: n = 692, mean age 65.5 (10.4) yr., 48.9% female]; 26% (158/610) of knee and 61% (423/692) of hip participants participated predominantly in home-based programs. A greater proportion of public recipients were obese and had greater pre-operative joint impairment, but participated more commonly in home programs [(Knee: 32.9% (79/240) vs 21.4% (79/370) ( P = 0.001); Hip: 71.0% (176/248) vs 55.6% (247/444) ( P < 0.001)], less commonly in inpatient rehabilitation [Knee: 7.5% (18/240) vs 56.0% (207/370) P (< 0.001); Hip: 4.4% (11/248) vs 33.1% (147/444) ( P < 0.001], and had fewer outpatient treatments [Knee: median (IQR) 6 (3) vs 8 (6) ( P < 0.001); Hip: 6 (4) vs 8 (6) ( P < 0.001)]. Conclusions Facility-based programs remain the norm for most knee and many hip arthroplasty recipients with insurance status being a major determinant of care. Development and implementation of evidence-based guidelines may help resolve the evidence-practice gap, addressing unwarranted practice variation across the insurance sectors. Electronic supplementary material The online version of this article (10.1186/s12891-019-2570-8) contains supplementary material, which is available to authorized use...

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Section: Introductionmentioning

confidence: 93%

Variation in rehabilitation setting after uncomplicated total knee or hip arthroplasty: a call for evidence-based guidelines

Naylor

Hart²,

Harris

et al. 2019

BMC Musculoskelet Disord

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“…and "What is your satisfaction with the surgical results?" (27). In the present survey we developed in this study, there are items related with physiotherapy service.…”

Section: Discussionmentioning

confidence: 99%

“…Some researchers used the Visual Analog Scale, which was rated between 0 and 10 without questionnaire in satisfaction evaluation (26). In another study, two questions were used to evaluate inpatient satisfaction after the surgery: “Would you repeat the same surgery under the same conditions?” and “What is your satisfaction with the surgical results?” (27). In the present survey we developed in this study, there are items related with physiotherapy service.…”

Section: Discussionmentioning

confidence: 99%

Orthopedics and Traumatology Inpatient Satisfaction Survey

Erden

Emirzeoğlu

2020

Journal of Patient Experience

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Inpatient satisfaction evaluation is essential for orthopedics serves. So the aim of this study was to develop a survey to evaluate the inpatients satisfaction in the orthopedics and traumatology service. The study was conducted with 102 patients (22 females and 80 males), who were hospitalized in an orthopedics and traumatology service. Data collection was performed with face to face interview. The survey development process was carried out in 4 steps: defining the problem and determining the subdimensions (1), composition an item pool (2), counselling expert (3), and reformation and implementation the survey (4). The final version of the survey have had 6 subdimensions: physiotherapist (1-3 items), inpatient administration (4,5 items), technical equipment and hygiene (6-8), doctor (9-11 items), nurse (12-14 items), and general satisfaction (15,16 items). In survey development process, internal consistency and item analysis were used for the reliability analysis. Cronbach alpha coefficient was calculated. The mean age of the participants was 41.43 ± 17.85 years, 85 of the patients underwent surgery on the knee, 13 on the hip, 3 on the leg, and 1 on the thigh. Six items were excluded from 22-itemed basic form of the survey as a result of the item analysis. The internal consistency of the final version of the survey was found good reliable (Cronbach alpha: 0.880). So health providers will be able to use it reliably on orthopedic inpatients speaking Turkish. Also it could be translate to other language to widely use.

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“…However, emerging remote clinical studies involving wearable technologies at Kaiser (15) suggest that the potential for fewer clinical visits and thus fewer copayments along with reduced time invested in appointments and travel to clinics would be strong motivators for initial adoption by patients. Home-based exercises (i.e., supervised or unsupervised) are preferred by patients who were recently discharged home after through-knee amputations due to convenience (28)(29)(30). Systematic reviews and meta-analyses have further confirmed that supervised rehabilitation exercises do not provide additional benefits when compared to home-based rehabilitation exercises (31)(32)(33).…”

Section: Cost Considerationsmentioning

confidence: 99%

Using Wearable Technologies to Monitor Physical Activity and Exercise in Patients: A Narrative Review

Sher,

Lewis,

Lin

2024

Curr Sports Med Rep

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With an increasing prevalence of sedentary lifestyles driving a prominent public health crisis, digital health tools such as wearable technologies are revolutionizing clinicians’ ability to track physical activity and exercise. Despite their ubiquity in the consumer market, these technologies have not yet been fully incorporated into clinical practice. Though these tools promise efficacy and accessibility, a careful review of the current literature is important to understand the challenges and future promise of clinical implementation. Important considerations of implementation include health maintenance and disease prevention, ease of use by patients and providers, incorporation into the electronic health record, cost considerations, safety, privacy, and ethical considerations. This narrative review describes the recent literature on the implementation of wearable technologies in the prescription of physical activity and exercise. Application of these technologies is promising for this field’s future.

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Inpatient rehabilitation did not positively affect 6‐month patient‐reported outcomes after hip or knee arthroplasty

Cited by 8 publications

References 17 publications

Variation in rehabilitation setting after uncomplicated total knee or hip arthroplasty: a call for evidence-based guidelines

Variation in rehabilitation setting after uncomplicated total knee or hip arthroplasty: a call for evidence-based guidelines

Orthopedics and Traumatology Inpatient Satisfaction Survey

Using Wearable Technologies to Monitor Physical Activity and Exercise in Patients: A Narrative Review

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