Physical rehabilitation versus no physical rehabilitation after total hip and knee arthroplasties: Protocol for a pragmatic, randomized, controlled, superiority trial (The DRAW1 trial)

Mark-Christensen, Troels; Thorborg, Kristian; Kallemose, Thomas; Bandholm, Thomas

doi:10.12688/f1000research.50814.1

Cited by 7 publications

(3 citation statements)

References 40 publications

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“…The users of telemedicine technologies in posthospital patient care process after THA are patients (at every stage of the process), physicians [ 13 , 14 , 23 , 24 , 38 ], physiotherapists [ 15 , 16 , 24 , 25 , 26 ], surgeons, [ 17 , 18 , 25 ], surgeon’s administrative assistants [ 17 ], health care team [ 27 ], and rehabilitation center [ 28 ].…”

Section: Resultsmentioning

confidence: 99%

Telemedicine Technologies Selection for the Posthospital Patient Care Process after Total Hip Arthroplasty

Kamecka

Foti

Gawiński

et al. 2022

IJERPH

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For many years, the importance of using telematic technologies in medicine has been growing, especially in the period of the coronavirus pandemic, when direct contact and supervision of medical personnel over the patient is difficult. The existing possibilities of modern information and communication technologies (ICTs) are not fully used. The aim of the study is to identify the telemedicine technologies that can be used in future implementation projects of the posthospital patient care process after total hip arthroplasty (THA). The literature search is reported according to PRISMA 2020. The search strategy included databases and gray literature. In total, 28 articles (EMBASE, PubMed, PEDro) and 24 records from gray literature (Google Search and Technology presentations) were included in the research. This multi-source study analyzes the possibilities of using different technologies useful in the patient care process. The conducted research resulted in defining visual and wearable types of telemedicine technologies for the original posthospital patient care process after THA. As the needs of stakeholders in the posthospital patient care process after THA differ, the awareness of appropriate technologies selection, information flow, and its management importance are prerequisites for effective posthospital patient care with the use of telemedicine technologies.

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Section: Resultsmentioning

confidence: 99%

Telemedicine Technologies Selection for the Posthospital Patient Care Process after Total Hip Arthroplasty

Kamecka

Foti

Gawiński

et al. 2022

IJERPH

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“…In patients with HA, adherence to a long-term IRP that includes specific physical therapy exercises performed preoperatively and postoperatively, associated with specific occupational therapy activities, including the use of adaptive devices (canes, crutches, walking frames) increases the patient's quality of life due to relief of symptoms (pain relief, increased strength of the muscles that cover the joint) and increased autonomy and improvement of joint functionality [27,28]. The compliance with a program of specific physiotherapy exercises shortens the hospitalization period and accelerates the recovery process [29].…”

Section: Discussionmentioning

confidence: 99%

Benefits of Combining Physical Therapy with Occupational Therapy in Hip Arthroplasty

Marcu

Negruț

Uivaraseanu

et al. 2021

JPM

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(1) Background: Hip arthroplasty (HA) is a surgery that replaces the damaged hip joint with an artificial implant called a hip prosthesis. The increase in life expectancy correlated with the population aging level, to which the increase in the number of prosthetic interventions among the young population is added, translates to the imperative need to analyze the quality of life beyond the immediate postoperative period. Strict adherence to an individualized rehabilitation program (IRP), and adapted to each patient, is followed by an improved quality of life. The main goal is the recovery of the patient with HA. This study was aimed to demonstrate that an IRP, represented by physical therapy associated with occupational therapy, improves the quality of life of patients with HA; (2) Methods: In this study, conducted between 2019 and 2021, 50 patients with HA were divided into two groups: study group—group A (25 subjects compliant with the IRP) and control group—group B (25 subjects, non-compliance with the IRP). To evaluate the two study groups, we monitored the evolution of the modified Harris hip score (mHHS) in both hips (arthroplasty hip (AH), contra lateral hip (CH)), for four months, respectively 30 days before the surgery (T0) and at 90 days after the surgery (T1); (3) Results: We notice significant differences in mHHS values at 90 days-T1 after surgery, both on AH in favor of subjects from group A vs. group B (p = 0.030) and on CH, where mHHS values were statistically higher in group A compared to group B (p < 0.001). The results of our study outline at T1 moment, both on the AH (p = 0.030) and on the CH (p < 0.001), the fact that mHHS values were statistically higher in patients included in group A compared to group B. In terms of the results for mHHS, comparing AH with CH, it is noted that the number of subjects who had a good or excellent mHHS result in group A versus group B is statistically significant in the case of CH (group A: 23 (92%) vs. group B: 11 (44%), p = 0.039); (4) Conclusions: The study reveals clear advantages of HA in both hips, both in subjects who complied with the IRP and those who did not comply; the higher therapeutic benefits of IRP are outlined at the level of CH compared to AH; in patients who comply with the IRP, the mHHS parameters that have improved in both CH and AH are pain, leaning, and shoes and socks activities; in addition, limping was reduced in CH.

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“…It has been difficult to show superiority of high‐intensity [10, 11] or supervised [12] rehabilitation exercise regimes over less intense or home‐based regimes on post‐operative recovery outcomes, such as functional performance and muscle strength. So, because it seems difficult to substantially impact post‐operative recovery after TKA when different rehabilitation exercise regimes are compared, we have recently asked whether rehabilitation exercise is superior to no rehabilitation exercise after TKA [13, 14]. This question is also relevant in UKA where the surgical trauma is smaller and where few studies have compared different rehabilitation regimes after UKA [15].…”

Section: Introductionmentioning

confidence: 99%

What is the effect of supervised rehabilitation regime vs. self-management instruction following unicompartmental knee arthroplasty? – a pilot study in two cohorts

et al. 2021

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Purpose The optimal rehabilitation strategy after a unicompartmental knee arthroplasty (UKA) is unclear. This study aims to compare the effect of transitioning from a supervised to a self-management rehabilitation regime by pilot study of patient outcomes subsequent to UKA surgery. Methods Fifty consecutive patients scheduled to undergo unilateral UKA surgery at our institution between 22nd February 2016 and 18thof January 2017 were prospectively identified via local medical database and included. Performed UKAs were grouped into two cohorts, Supervised Cohort and Self-management Cohort, temporally separated by introduction of new rehabilitation. Self-management Cohort(n = 25) received an extensive inpatient rehabilitation regime along with outpatient referral to rehabilitation center. The Self-management Cohort(n = 25) were only instructed in use of crutches and free ambulation at own accord. Follow-up (F/U) was 1 year from receiving UKA. A range of outcomes were recorded, and between-cohort differences compared: knee joint range of motion, pain and functional limitations, length of stay (LOS), readmission rate, pain during activity and rest, and knee circumference. Results Complete data was obtained for n = 45 patients. The mean between-cohort difference in ROM (range of motion) from preoperatively to discharge was 15.4 degrees (CI:5.2,25.8, p = 0.004), favoring the supervised regime, with no difference detected in any outcome at 3- or 12 months F/U. Median LOS was 1 day in both cohorts. Conclusion Transition to a simple rehabilitation regime following UKA surgery was associated with decreased ROM at discharge, which was not present at 3-month F/U. We found no other between-cohort differences for any other outcomes at 3- and 12-month F/U including functional limitations, although the study was likely underpowered for these outcomes. We encourage large-scale replication of these findings using randomized designs. Level of evidence Therapeutic level II

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Physical rehabilitation versus no physical rehabilitation after total hip and knee arthroplasties: Protocol for a pragmatic, randomized, controlled, superiority trial (The DRAW1 trial)

Cited by 7 publications

References 40 publications

Telemedicine Technologies Selection for the Posthospital Patient Care Process after Total Hip Arthroplasty

Telemedicine Technologies Selection for the Posthospital Patient Care Process after Total Hip Arthroplasty

Benefits of Combining Physical Therapy with Occupational Therapy in Hip Arthroplasty

What is the effect of supervised rehabilitation regime vs. self-management instruction following unicompartmental knee arthroplasty? – a pilot study in two cohorts

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