Multidisciplinary rehabilitation after primary total knee arthroplasty: a randomized controlled study of its effects on functional capacity and quality of life

Kauppila, Anna-Maija; Kyllönen, Eero; Ohtonen, Pasi; Hämäläinen, Martti; Mikkonen, Paula; Laine, Vesa; Siira, Pertti; Mäki-Heikkilä, Paula; Sintonen, Harri; Leppilahti, Juhana; Arokoski, Jari

doi:10.1177/0269215509346089

Cited by 61 publications

(107 citation statements)

References 35 publications

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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%

“…The main potential source of bias was from large and unequal losses to follow-up in six studies. 514,588,[591][592][593][594] Two further studies were judged to be of reasonable quality with overall losses to follow-up of between 10% and 20%. 600,602 There was no suggestion of risk of bias in nine studies.…”

Section: Study Qualitymentioning

confidence: 99%

“…514,591,[596][597][598] Studies reported WOMAC physical function, OKS, KOOS ADL scale or Iowa Level of Assistance Scale (ILAS) total score. As shown in the meta-analysis in Table 96 and Figure 49, in three studies with 254 patients, physiotherapy exercise was associated with an improvement in physical function at 3-4 months (average SMD -0.37, 95% CI -0.62 to -0.12; p = 0.004).…”

Section: Physiotherapy Exercise Compared With No Interventionmentioning

confidence: 99%

“…588,591,597,598 Studies reported WOMAC pain, KOOS pain or OKS pain. As shown in Table 96 and Figure 50, in two studies with 103 patients a pain outcome was reported at 3-4 months with an average SMD of -0.45 (95% CI -0.85 to -0.06; p = 0.02) favouring physiotherapy exercise.…”

Section: Patient-reported Painmentioning

confidence: 99%

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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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Section: Intervention Focusmentioning

confidence: 99%

Section: Study Qualitymentioning

confidence: 99%

Section: Physiotherapy Exercise Compared With No Interventionmentioning

confidence: 99%

Section: Patient-reported Painmentioning

confidence: 99%

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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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“…Existen diversas formas de tratamiento una vez que el paciente es intervenido de artroplastia de rodilla: en unidades de rehabilitación para procesos subagudos; fisioterapia ambulatoria; a domicilio, asistidos por fisioterapeutas; sólo asesorados por folletos con ejercicios; rehabilitación multidisciplinaria 13 , etc. Por ello, aún hay controversias sobre cuál es la forma más efectiva para su aplicación.…”

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La rehabilitación y fisioterapia domiciliaria en las prótesis de rodilla

López-Liria

Vega-Ramírez

Catalán-Matamoros

et al. 2012

Anales Sis San Navarra

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Economic evaluation of multidisciplinary rehabilitation after primary total knee arthroplasty based on a randomized controlled trial

Kauppila

Sintonen

Aronen

et al. 2011

Arthritis Care & Research

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Objective. To conduct an economic evaluation of a multidisciplinary, biopsychosocial outpatient rehabilitation program implemented 2-4 months after total knee arthroplasty (TKA), compared with conventional orthopedic care. Methods. After surgery, 86 patients were randomized to a multidisciplinary rehabilitation group (n ‫؍‬ 44) or a conventional orthopedic care group (n ‫؍‬ 42). Alongside the randomized controlled trial, we estimated the costs of rehabilitation, health care resource use, and community support. Information about resource use was collected by means of a questionnaire together with data from hospital records. The primary outcome (effectiveness) measure was change in self-reported functional capacity and the secondary measure was quality-adjusted life years (QALYs) gained during the 12-month followup. Cost-effectiveness was assessed from between-group differences in costs, change in functional capacity, and QALYs gained. Results. Both protocols of providing rehabilitation services turned out to be equally effective, but the conventional orthopedic care protocol was unequivocally cost saving: the saving was €1,830 per patient (95% confidence interval ؊548, 3,623) using the available direct cost data. Conclusion. Multidisciplinary rehabilitation for unselected osteoarthritis patients in the subacute period of recovery after TKA is not a cost-effective use of health care resources. Similar rehabilitation protocols cannot be recommended for clinical pathways of TKA in the future.

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Multidisciplinary rehabilitation after primary total knee arthroplasty: a randomized controlled study of its effects on functional capacity and quality of life

Cited by 61 publications

References 35 publications

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

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

La rehabilitación y fisioterapia domiciliaria en las prótesis de rodilla

Economic evaluation of multidisciplinary rehabilitation after primary total knee arthroplasty based on a randomized controlled trial

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