A clinical practice guideline on total knee arthroplasty was developed by an American Physical Therapy (APTA) volunteer guideline development group that consisted of physical therapists, an orthopedic surgeon, a nurse, and a consumer. The guideline was based on systematic reviews of current scientific and clinical information and accepted approaches to management of total knee arthroplasty.

Improved functional capacity was associated with enhanced HR-QOL. At 6 months, walking distances remained 75% of those for age-matched peers who had normal weight.

The 6MWT, 10MWT, 30STS, and LASF are reliable measurement instruments for patients treated for HNC. The 6MWT, 10MWT, and 30STS are significantly correlated suggesting they may measure subconstructs of physical function. The LASF does not correlate significantly with the 6MWT, 10MWT and 30STS in this sample.

Objective Using AM-PAC “6-Clicks” scores at initial physical therapist and/or occupational therapist evaluation to assess: (1) predictive ability for community versus institution discharge and (2) association with discharge destination (home/self-care [HOME], home health [HHA], skilled nursing facility [SNF], and inpatient rehabilitation facility [IRF]). Methods In this retrospective cohort study, initial “6-Clicks” Basic Mobility (6CBM) and/or Daily Activity (6CDA) t scores and discharge destination were obtained from electronic health records of 17,546 inpatient admissions receiving physical therapy/occupational therapy at an academic hospital between 10/1/15–8/31/18. For objective (1), postacute discharge destination was dichotomized to community (HOME and HHA) and institution (SNF and IRF). Receiver operator characteristic curves determined the most predictive 6CBM and 6CDA scores for discharge destination. For objective (2), adjusted odds ratios (OR) from multinomial logistic regression assessed association between discharge destination (HOME, HHA, SNF, IRF) and cut-point scores for 6CBM (≤40.78 vs > 40.78) and 6CDA (≤40.22 vs > 40.22), accounting for patient and clinical characteristics. Results Area under the curve (AUC) for 6CBM was 0.80 (95% CI = 0.80–0.81) and 6CDA was 0.81 (95% CI = 0.80–0.82). The best cut-point for 6CBM was 40.78 (raw score = 16; sensitivity = 0.71 and specificity = 0.74) and for 6CDA was 40.22 (raw score = 19; sensitivity = 0.68 and specificity = 0.79). 6CBM and 6CDA were significantly associated with discharge destination, with those above the cut-point resulting in increased odds of discharge HOME. The 6CBM scores ≤ 40.78 had higher odds of discharge to HHA (OR = 1.7 [95% CI = 1.5–1.9]), SNF (OR = 7.8 [95% CI = 6.8–8.9]), and IRF (OR = 7.5 [95% CI = 6.3–9.1]) 6CDA scores ≤ 40.22 had higher odds of discharge to HHA (OR = 1.8 [95% CI = 1.7–2.0]), SNF (OR = 8.9 [95% CI = 7.9–10.0]), and IRF (OR = 11.4 [95% CI = 9.7–13.5]). Conclusions “6-Clicks” at physical therapist/occupational therapist initial evaluation demonstrated good prediction for discharge decisions. Higher scores were associated with discharge to HOME; lower scores reflected discharge to settings with increased support levels. Impact Initial 6CBM and 6CDA scores are valuable clinical tools in the determination of discharge destination.