Rehabilitation for Total Hip Arthroplasty: A Systematic Review

Konnyu, Kristin J.; Pinto, Dan; Cao, Wangnan; Aaron, Roy K.; Panagiotou, Orestis A.; Bhuma, Monika Reddy; Adam, Gaelen P; Balk, Ethan M; Thoma, Louise M.

doi:10.1097/phm.0000000000002007

Cited by 14 publications

(10 citation statements)

References 37 publications

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“…All gait cycles involved in turning were excluded from the final analysis. Two weeks postoperatively was identified as an appropriate timeframe when most patients with THA or TKA have weaned off assistive devices and beginning to walk independently [ 24 , 25 ]. Ten weeks postoperatively was identified as most of the physical recovery of walking is obtained by this timeframe [ 24 , 25 ].…”

Section: Methodsmentioning

confidence: 99%

The validity and reliability of the OneStep smartphone application under various gait conditions in healthy adults with feasibility in clinical practice

et al. 2022

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Objective Primary purpose of this study was to determine the validity and reliability of the OneStep smartphone application in healthy adults. Secondary purpose was to determine the feasibility of measuring gait dysfunction, limitation in spatiotemporal characteristics, longitudinally in patients following total hip or knee arthroplasty. Methods First objective, 20 healthy adults (mean age, 42.3 ± 19.7 years; 60% males; mean body mass index, 29.0 ± 5.2 kg/m2) underwent gait analysis under four gait conditions (self-selected gait speed, fixed gait speed at 0.8 m/s, fixed gait speed at 2.0 m/s and self-selected gait speed with dual task) for the validity and reliability of the smartphone to the motion laboratory. Reliability was determined by intraclass correlation coefficients. Validity was determined by Pearson correlations. Agreement was assessed by the Bland–Altman method. Second objective, 12 additional patients with total hip or knee arthroplasty (mean age, 58.7 ± 6.5 years; 58% males; mean body mass index, 28.9 ± 5.8 kg/m2) were measured at 2- and 10 weeks postoperatively. The smartphone application was used to evaluate change in gait dysfunction over time within the patients’ own environment using paired t test. Results The smartphone application demonstrated moderate-to-excellent intraclass correlation coefficients for reliability between-system (ICC range, 0.56–0.99), -limb (ICC range, 0.62–0.99) and -device (ICC range, 0.61–0.96) for gait analysis of healthy adults. Pearson correlations were low-to-very high between methods (r range, 0.45–0.99). Bland–Altman analysis revealed relative underestimation of spatiotemporal variables by the smartphone application compared to the motion system. For patients following total hip or knee arthroplasty, gait analysis using the OneStep application demonstrated significant improvement (p < 0.001, Cohen’s d > 0.95) in gait dysfunction between 2- and 10 weeks postoperatively. Conclusion The smartphone application can be a valid, reliable and feasible alternative to motion laboratories in evaluating deficits in gait dysfunction in various environments and clinical settings.

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Section: Methodsmentioning

confidence: 99%

The validity and reliability of the OneStep smartphone application under various gait conditions in healthy adults with feasibility in clinical practice

et al. 2022

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“…These conclusions are striking given rehabilitation is the standard practice to achieve optimal range of motion, reduce fibrosis and scar formation after TKA. This lack of evidence to adequately guide rehabilitation practice for TKA parallels those reported in a companion article that reviewed the comparative effectiveness of rehabilitation interventions for patients who have undergone THA 13 but is even more striking given the substantially larger number of patients that undergo TKA versus THA annually (680,150 vs. 370,770 based on 2014 estimates) 88 and the fact that the evidence base for TKA is more than 3 times as large as THA (53 vs. 16 studies).…”

Section: Discussionmentioning

confidence: 83%

“…The factors contributing to this lack of evidence are multifaceted and are reported in more detail in our companion THA article 13 as well as a commentary on the challenges of using evidence to inform a clinical practice guideline on rehabilitation for TKA 89 . Briefly, these factors include the:…”

Section: Discussionmentioning

confidence: 99%

“…At minimum, this would include designing interventions using some form of standardized taxonomy to define intervention content (such as the taxonomy used to code content in this review), 91 transparently reporting the complete content of interventions (e.g., using the Template for Intervention Description and Replication checklist to ensure comprehensive reporting of all intervention elements), 92 and evaluating the impact of interventions using a minimum core set of outcomes evaluated across all trials 93,94 . A more in depth description of the next steps needed in rehabilitation research based on the current state of the evidence can be found in the THA and Jette et al articles 13,89 …”

Section: Discussionmentioning

confidence: 99%

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Rehabilitation for Total Knee Arthroplasty: A Systematic Review

Konnyu

Thoma

Cao

et al. 2022

Am J Phys Med Rehabil

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“…In this article, we address the effects and harms of prehabilitation for patients who will undergo TKA or THA on patient-reported outcomes, performance-based outcomes, and healthcare utilization after surgery. In companion articles, we address rehabilitation after TKA 12 and THA 13 …”

Section: Introductionmentioning

confidence: 99%

Prehabilitation for Total Knee or Total Hip Arthroplasty: A Systematic Review

Konnyu

Thoma

Cao

et al. 2022

Am J Phys Med Rehabil

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We sought to systematically review the evidence on the benefits and harms of prehabilitation interventions for patients who are scheduled to undergo elective, unilateral total knee arthroplasty or total hip arthroplasty surgery for the treatment of primary osteoarthritis. We searched PubMed, Embase, The Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, Scopus, and ClinicalTrials.gov from January 1, 2005, through May 3, 2021. We selected for inclusion randomized controlled trials and adequately adjusted nonrandomized comparative studies of prehabilitation programs reporting performancebased, patient-reported, or healthcare utilization outcomes. Three researchers extracted study data and assessed risk of bias, verified by an independent researcher. Experts in rehabilitation content and complex interventions independently coded rehabilitation interventions. The team assessed strength of evidence. While large heterogeneity across evaluated prehabilitation programs limited strong conclusions, evidence from 13 total knee arthroplasty randomized controlled trials suggest that prehabilitation may result in increased strength and reduced length of stay and may not lead to increased harms but may be comparable in terms of pain, range of motion, and activities of daily living (all low strength of evidence). There was no evidence or insufficient evidence for all other outcomes after total knee arthroplasty. Although there were six total hip arthroplasty randomized controlled trials, there was no evidence or insufficient evidence for all total hip arthroplasty outcomes.

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Rehabilitation for Total Hip Arthroplasty: A Systematic Review

Abstract: We sought to determine the comparative benefits and harms of rehabilitation interventions for patients who have undergone elective, unilateral THA surgery for the treatment of primary osteoarthritis. We searched PubMed, Embase, The Cochrane Register of Clinical Trials,

Cited by 14 publications

References 37 publications

The validity and reliability of the OneStep smartphone application under various gait conditions in healthy adults with feasibility in clinical practice

The validity and reliability of the OneStep smartphone application under various gait conditions in healthy adults with feasibility in clinical practice

Rehabilitation for Total Knee Arthroplasty: A Systematic Review

Prehabilitation for Total Knee or Total Hip Arthroplasty: A Systematic Review

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