Integrated care programmes for sport and work participation, performance of physical activities and quality of life among orthopaedic surgery patients: a systematic review with meta-analysis

Abstract

ObjectivesOrthopaedic surgery is primarily aimed at improving function and pain reduction. Additional integrated care may enhance patient’s participation in sports and work, possibly improving performance of physical activities and quality of life (QoL). We aimed to assess the effectiveness of integrated care among orthopaedic surgery patients.DesignSystematic review with meta-analysis.Data sourceMedline, EMBASE and CINAHL (until 17 June 2019).Eligibility for selecting studiesWe searched for controlled studies on integrated care interventions consisting of active referral to case managers, rehabilitation with participation-based goals and/or e/mHealth, with outcomes of sports and work participation, performance of physical activities and/or QoL. Outcomes were normalised to 0–100 scales and statistically pooled.ResultsSeventeen articles (n=2494) of moderate quality were included reporting on patients receiving back, upper limb, knee or hip surgery. Only one study reported on return to sports and found no significant benefit. For return to work, one study did (90% vs 82%) and one did not (relative risk=1.18 (0.80 to 1.70)) observe significant benefits. Integrated care showed small effects for improving performance of physical activities (2.69 (–0.20 to 5.58); eight studies, n=1267) and QoL (2.62 (1.16 to 5.05); nine studies, n=1158) compared with usual care.Summary/ConclusionWe found insufficient and inconsistent evidence for the effectiveness of integrated care for orthopaedic surgery patients regarding sport and work participation. Small effects were found for performance of physical activities and QoL. High quality research on integrated care focusing on sports and work participation is needed before integrated care can be implemented for orthopaedic surgery patients.

Prevention at work needed to curb the worldwide strong increase in knee replacement surgery for working-age osteoarthritis patients

“…These consequences receive little-to-no attention in current clinical guidelines and yet are increasingly important outcomes for patients of working age ( 17 , 18 ). Therefore, occupational health professionals around the world face the urgent challenge to develop evidence of how to improve a patient’s ability for sustained employability – as an essential value in life – after surgery ( 19 ). Promising initiatives have recently been described although not validated for work participation yet ( 20 – 23 ).…”

Telenursing in Physical and Occupational Therapists’ Training

“…Although, the information on the key criterion of the effectiveness of rehabilitation is quite homogeneous. Thus, Р. Coenen, G. Hulsegge, J. G. Daams, et al [7] came to the conclusion that the effectiveness of integrated care programs and rehabilitation for postoperative patients should be measured by their ability to participate in work and sport. Next, the authors conducted meta-analysis, which shows that insufficient attention of researchers to the criterion of returning of postoperative patients to other activities, besides domestic self-care, is the reason for the distortion of data on the quality of rehabilitation.…”

“…Next, the authors conducted meta-analysis, which shows that insufficient attention of researchers to the criterion of returning of postoperative patients to other activities, besides domestic self-care, is the reason for the distortion of data on the quality of rehabilitation. The information presented by the authors [7] is used together with authors' data [10] while choosing the subject of the experimental rehabilitation experiment (teacher), as well as while teaching the students the basics of psychological support of a client.…”

“…The researchers of the problem of psychological and pedagogical aspects of physical therapists training focus on the following problems: the correlation of direct and indirect interactions in both professional and educational activities (Rezaei M., Jalali R. et al [4], Fukumoto M., Watanabe T., et al [5], Hughes E., Bradford J., Likens C. [6]). They also concentrate on the impact of socio-demographic and personal, the so-called, contextual, factors, on the effectiveness of interactions of the rehabilitation process (Coenen P., Hulsegge G., Daams J. G., et al [7], Covington K. and Barcinas S. J. [8], Mun C. J., Davis M. C., et al [9], Morera-Balaguer J., Botella-Rico J. M., et al [10], Yehorova Y. V. and others, edited by Ihnatovych О. М.…”

Development of a Personalized m/eHealth Algorithm for the Resumption of Activities of Daily Life Including Work and Sport after Total and Unicompartmental Knee Arthroplasty: A Multidisciplinary Delphi Study

“…A recent review demonstrated that the resumption of activities of daily life after knee arthroplasty can be improved with the help of integrated care programs, such as those provided by m/eHealth [18]. m/eHealth has the possibility to provide personalized and adaptive guidance to patients.…”