Is group-based physical therapy superior to individual rehabilitation in elderly adults after total knee arthroplasty? A prospective observational study

Abstract

Knee osteoarthritis (OA) is the most prevalent joint disease and one of the leading causes of disability, poor physical activity levels (PAL), and quality of life (Qol) of elderly people worldwide. The purpose of this study was to evaluate the superiority of a novel group-based physical therapy (GBPT) intervention compared to a more traditional one-to-one individual physical therapy (IPT) among elderly Bulgarian subjects underwent total knee arthroplasty (TKA). One hundred and thirty elderly TKA recipients of both genders with mean age=72.69±0.44 were randomly assigned to GBPT or to one-to-one IPT. Elderly participants were assessed at baseline and at 3 and 6 months after both rehabilitation interventions, with the use of the following evaluation tools: Physical Activity Scale for the Elderly (PASE), Six-Minute Walk Test (6MWT), and Short Form Health Survey questionnaire (SF-36v2). At 6 months elderly TKA recipients who received GBPT achieved 7.36 points more in the PASE questionnaire when compared with the IPT group. Elderly participants of the GBPT group walked significantly longer distance during the 6MWT than TKA recipients attended IPT, respectively 421.56 m vs. 398.62 m, (p< 0.001). Furthermore, significantly greater improvement in health-related quality of life (HRQoL) was obtained from the elderly participants of the GBPT arm compared with the participants of the IPT arm, respectively 70, 7% vs. 60, 8% at 6 months follow up. We conclude that our results suggest the superiority of the GBPT in terms of PAL (PASE score, 6MWT) and HRQoL among elderly TKA recipients across the first 6 months.

Sufentanil Improves the Analgesia Effect of Continuous Femoral Nerve Block After Total Knee Arthroplasty

“…The purpose of this study was primarily to determine whether sufentanil could enhance the analgesic effect of ropivacaine and whether the effect could be achieved through local action. The results showed that (1) VAS score in RS group was significantly lower than that in R group; (2) The satisfaction of analgesia in RS group was significantly higher than that in R group; (3) The use of morphine in RS group was significantly lower than that in R group on the first and second postoperative days; (4) The number of sleep interruption and painful compressions on the first postoperative day in RS group was significantly lower than that in R group; (5) During follow-up 30 days after discharge, no neuro-related complications were observed. The results showed that VAS score in RS group was significantly lower than that in R group, suggesting that sufentanil can improve the analgesic effect of ropivacaine in cFNB after TKA.…”

“…Total knee arthroplasty (TKA) is one of the most effective surgical treatment methods for pain relief and functional recovery in patients with end-stage knee arthritis. 2 With the maturity of artificial TKA, TKA has achieved good results. Strictly grasping the surgical indications for bilateral TKA can avoid two surgeries, shorten recovery time, reduce medical costs, and ensure good safety.…”