The Effect of a Multidimensional Home Rehabilitation Program for Post-Total Knee Arthroplasty Elderly Patients

Abstract

Patients with total knee arthroplasty (TKA) experience pain, decreased muscle strength, and decreased knee function, resulting in increases in depression and decreased subjective well-being. A multidimensional home program may prevent these adverse events. The aim of this study was to test the effect of a home rehabilitation program that included education, exercise, aroma massage, and phone counseling for post-TKA patients. We used a randomized control group pretest/posttest design. Fifty-nine patients participated, with 29 in the experimental group and 30 in the control group. Pain, knee joint range of motion (ROM), quadriceps strength, depression, and subjective well-being were measured as outcome variables. Data were analyzed using repeated-measures analysis of variance and generalized estimating equations. The experimental group showed significant improvement in knee pain, active ROM, muscle strength, depression, and subjective well-being with no significant between-groups difference in passive ROM. The multidimensional home rehabilitation program can be an effective nursing intervention for physical and emotional recovery of patients with TKA.

Efficacy and safety of continuous nursing in improving functional recovery after total hip or knee arthroplasty in older adults: A systematic review

“…There were seven studies on continuing nursing care for older patients after knee replacement [ [23] , [24] , [25] , [26] , [27] , [28] , [29] ], including four RCTs [ 23 , 25 , 28 , 29 ] and three cohort studies [ 24 , 26 , 27 ]. There were six studies on the continuing care of older adults after hip replacement [ [30] , [31] , [32] , [33] , [34] , [35] ], including five RCTs [ [31] , [32] , [33] , [34] , [35] ] and one cohort study [ 30 ].…”

“…Among the included literature, there were two studies [ 36 , 37 ], including THA and TKA, both of which are cohort-controlled studies. Totally, the review encompassed 15 studies [ [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] ], comprising six cohort studies [ 24 , 26 , 27 , 30 , 36 , 37 ] and nine RCTs [ 23 , 25 , 28 , 29 , [31] , [32] , [33] , [34] , [35] ], involving 34,186 patients. The essential characteristics of the included literature are shown in Table 1 .…”

“… Age: >60 F/M: 47/52 IG/CG: 49/50 Guo et al., 2022 [ 34 ] China RCT THA n = 104 3 months Intervention: Continuous nursing care based on clinical nursing pathway and Omaha System theory Control: Routine nursing HHS, Barthel index score, and ADL scale Continuous nursing care has a better effect on promoting the recovery of hip joint function, improving the quality of life, and reducing anxiety and depression in elderly patients with total hip replacement. Age: >60 F/M: 51/53 IG/CG: 53/51 Park et al., 2023 [ 29 ] Korea RCT TKA n = 57 12 weeks Intervention: Multidimensional home rehabilitation Control: Traditional rehabilitation Knee Pain, knee ROM, muscle strength of the knee Multi-dimensional home rehabilitation program can be used as an effective nursing intervention for physical and mental recovery of TKA patients. Age: >60 F/M: 51/6 IG/CG: 29/28 Wu et al., 2023 [ 35 ] China RCT THA n = 85 6 months Intervention: Continuous nursing care based on telehealth rehabilitation Control: Routine nursing HHS, FIM, SAS, postoperative complications The Internet-based transitional care model can promote joint rehabilitation and reduce the incidence of complications.…”

“…Only one of the 15 studies was conducted in 2016 [ 36 ]; the rest were after 2018 [ [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , 37 ]. There were six studies on postoperative hip replacement [ [30] , [31] , [32] , [33] , [34] , [35] ], four from China [ [32] , [33] , [34] , [35] ], one from Australia [ 31 ], and one from the United States [ 30 ].…”

“…There were six studies on postoperative hip replacement [ [30] , [31] , [32] , [33] , [34] , [35] ], four from China [ [32] , [33] , [34] , [35] ], one from Australia [ 31 ], and one from the United States [ 30 ]. Seven studies on continuing nursing care after knee replacement [ [23] , [24] , [25] , [26] , [27] , [28] , [29] ], three from the United States [ 24 , 26 , 27 ], two from South Korea [ 25 , 29 ], one from Thailand [ 23 ], and one from Finland [ 28 ]. The two studies involving both THA and TKA, are from the United States [ 36 , 37 ].…”