The effect of telerehabilitation on early outcomes in patients undergoing primary total knee replacement: A prospective randomized study

Authors

Keywords:

Total knee arthroplasty, Telerehabilitation, Knee society score, WOMAC, Barthel index, SF-36

Abstract

Background/Aim: The continuity of rehabilitation is a problem after arthroplasty operations. There is a need for accessible rehabilitation programs for patients. The purpose of this study is to determine the difference in knee functions and patients' quality of life between patients doing home telerehabilitation and home rehabilitation after total knee arthroplasty (TKA). Methods: This prospective study was conducted on 90 patients, between June 2019 and January 2021. Patients are divided into three groups. Patients in group 1 are told to continue with the daily routine exercises which began in hospital. Group 2 patients got an information message to their mobile phones every day for the first month, reminding them of their postoperative exercises, whereas patients in group 3 are called by mobile phone for the same reminding. All patients participating in the study were evaluated by completing the Universities of Western Ontario and McMaster Osteoarthritis Index (WOMAC) scores, the Knee Society Clinical Evaluation System (KSS), the Barthel Index (BI) and the Quality of Life Scale Short Form 36 (SF-36) preoperatively and in the first and third months postoperatively, and the differences between the groups based on these scores were evaluated. Results: There was a statistically significant difference in WOMAC between the groups regarding first-month and third-month postoperatively (P=0.004 and P<0.001, respectively), as well as in KSS values between the same groups (P=0.048 and P=0.036, respectively). There was no statistically significant difference between the groups regarding postoperative first-month BI (P=0.826) and SF-36 values (P=0.264). There was a statistically significant difference between the groups regarding postoperative third-month BI and SF-36 values (P=0.035 and P<0.001, respectively). Conclusion: The telerehabilitation therapy appears to be more effective and successful than the control group, as shown by improvements in overall physical functions.

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References

Guccione AA, Felson DT, Anderson JJ, Anthony JM, Zhang Y, Wilson PW et al. The effects of specific medical conditions on the functional limitations of elders in the Framingham Study. Am J Public Health. 1994 Mar;84(3):351-8.

Zhang Y, Jordan JM. Epidemiology of osteoarthritis. Clin Geriatr Med. 2010 Aug;26(3):355-69.

Malkani AL, Rand JA, Bryan RS, Wallrichs SL. Total knee arthroplasty with the kinematic condylar prosthesis. A ten-year follow-up study. J Bone Joint Surg Am. 1995 Mar;77(3):423-31.

Ranawat CS, Boachie-Adjei O. Survivorship analysis and results of total condylar knee arthroplasty. Eight- to 11-year follow-up period. Clin Orthop Relat Res. 1988 Jan;(226):6-13.

Bohannon RW, Cooper J. Total knee arthroplasty: evaluation of an acute care rehabilitation program. Arch Phys Med Rehabil. 1993 Oct;74(10):1091-4.

Dowsey MM, Kilgour ML, Santamaria NM, Choong PFM. Clinical pathways in hip and knee arthroplasty: A prospective randomised controlled study. Med J Aust. 1999 Jan 18;170(2):59–62.

Lingard EA, Berven S, Katz JN; Kinemax Outcomes Group. Management and care of patients undergoing total knee arthroplasty: variations across different health care settings. Arthritis Care Res. 2000 Jun;13(3):129-36.

Kramer JF, Speechley M, Bourne R, Rorabeck C, Vaz M. Comparison of clinic- and home-based rehabilitation programs after total knee arthroplasty. Clin Orthop Relat Res. 2003 May;(410):225-34.

Theodoros D, Russell T. Telerehabilitation: current perspectives. Stud Health Technol Inform. 2008;131:191-209.

Russell TG. Telerehabilitation: a coming of age. Aust J Physiother. 2009;55(1):5-6.

Amatya B, Galea MP, Kesselring J, Khan F. Effectiveness of telerehabilitation interventions in persons with multiple sclerosis: A systematic review. Mult Scler Relat Disord. 2015 Jul;4(4):358-69.

Cotelli M, Manenti R, Brambilla M, Gobbi E, Ferrari C, Binetti G, et al. Cognitive telerehabilitation in mild cognitive impairment, Alzheimer’s disease and frontotemporal dementia: A systematic review. J Telemed Telecare. 2019 Feb 1;25(2):67–79.

Cramer SC, Dodakian L, Le V, See J, Augsburger R, McKenzie A, et al.; National Institutes of Health StrokeNet Telerehab Investigators. Efficacy of Home-Based Telerehabilitation vs In-Clinic Therapy for Adults After Stroke: A Randomized Clinical Trial. JAMA Neurol. 2019 Sep 1;76(9):1079-87.

Cheville AL, Moynihan T, Herrin J, Loprinzi C, Kroenke K. Effect of Collaborative Telerehabilitation on Functional Impairment and Pain Among Patients With Advanced-Stage Cancer: A Randomized Clinical Trial. JAMA Oncol. 2019 May 1;5(5):644-52.

Chan C, Yamabayashi C, Syed N, Kirkham A, Camp PG. Exercise Telemonitoring and Telerehabilitation Compared with Traditional Cardiac and Pulmonary Rehabilitation: A Systematic Review and Meta-Analysis. Physiother Can. 2016;68(3):242-51.

Reeder B, Chung J, Stevens-Lapsley J. Current telerehabilitation research with older adults at home. J Gerontol Nurs. 2016;42(10):15–20.

Bashshur R, Shannon G, Krupinski E, Grigsby J. The taxonomy of telemedicine. Telemed J E Health. 2011 Jul-Aug;17(6):484-94.

Tousignant M, Moffet H, Boissy P, Corriveau H, Cabana F, Marquis F. A randomized controlled trial of home telerehabilitation for post-knee arthroplasty. J Telemed Telecare. 2011 Jun;17(4):195–8.

Russell TG, Buttrum P, Wootton R, Jull GA. Internet-based outpatient telerehabilitation for patients following total knee arthroplasty: a randomized controlled trial. J Bone Joint Surg Am. 2011 Jan 19;93(2):113-20.

Aliyev RM. Alloarthroplastischer Hüftgelenkersatz mit dem Staffelstein-Score: Ergebnisevaluation der stationären Rehabilitation [Total hip replacement using the Staffelstein score: outcome of inpatient rehabilitation]. Orthopade. 2010 Dec;39(12):1163-70.

Khan F, Ng L, Gonzalez S, Hale T, Turner-Stokes L. Multidisciplinary rehabilitation programmes following joint replacement at the hip and knee in chronic arthropathy. Cochrane Database Syst Rev. 2008 Apr 16;(2):CD004957.

Westby MD, Brittain A, Backman CL. Expert consensus on best practices for post-acute rehabilitation after total hip and knee arthroplasty: a Canada and United States Delphi study. Arthritis Care Res (Hoboken). 2014 Mar;66(3):411-23.

Sibold M, Mittag O, Kulick B, Müller E, Opitz U, Jäckel WH. Prädiktoren der Teilnahme an einer Nachsorge nach ambulanter Rehabilitation bei erwerbstätigen Rehabilitanden mit chronischen Rückenschmerzen1 [Predictors of participation in medical rehabilitation follow-up in working patients with chronic back pain]. Rehabilitation (Stuttg). 2011 Dec;50(6):363-71.

Pastora-Bernal JM, Martín-Valero R, Barón-López FJ, Estebanez-Pérez MJ. Evidence of benefit of telerehabitation after orthopedic surgery: A systematic review. J Med Internet Res. 2017 Apr 1;19(4).

Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988 Dec;15(12):1833-40.

Scuderi GR, Bourne RB, Noble PC, Benjamin JB, Lonner JH, Scott WN. The new Knee Society Knee Scoring System. Clin Orthop Relat Res. 2012 Jan;470(1):3-19.

Mahoney FI, Barthel DW. Functional Evaluation: The Barthel Index. Md State Med J. 1965 Feb;14:61-5.

Gandek B, Ware JE Jr, Aaronson NK, Alonso J, Apolone G, Bjorner J, et al. Tests of data quality, scaling assumptions, and reliability of the SF-36 in eleven countries: results from the IQOLA Project. International Quality of Life Assessment. J Clin Epidemiol. 1998 Nov;51(11):1149-58.

Campbell R, Evans M, Tucker M, Quilty B, Dieppe P, Donovan JL. Why don't patients do their exercises? Understanding non-compliance with physiotherapy in patients with osteoarthritis of the knee. J Epidemiol Community Health. 2001 Feb;55(2):132-8.

Sluijs EM, Kok GJ, Van der Zee J, Turk DC, Riolo L. Correlates of exercise compliance in physical therapy. Phys Ther. 1993;73(11):771–86.

O'Brien N, McDonald S, Araújo-Soares V, Lara J, Errington L, Godfrey A, et al. The features of interventions associated with long-term effectiveness of physical activity interventions in adults aged 55-70 years: a systematic review and meta-analysis. Health Psychol Rev. 2015;9(4):417-33.

Kauppila AM, Kyllönen E, Ohtonen P, Hämäläinen M, Mikkonen P, Laine V, et al. Multidisciplinary rehabilitation after primary total knee arthroplasty: A randomized controlled study of its effects on functional capacity and quality of life. Clin Rehabil. 2010 May;24(5):398–411.

Mahomed NN, Barrett J, Katz JN, Baron JA, Wright J, Losina E. Epidemiology of total knee replacement in the United States Medicare population. J Bone Joint Surg Am. 2005 Jun;87(6):1222-8.

Charnock D, Shepperd S, Needham G, Gann R. DISCERN: an instrument for judging the quality of written consumer health information on treatment choices. J Epidemiol Community Health. 1999 Feb;53(2):105-11.

Tribe KL, Lapsley HM, Cross MJ, Courtenay BG, Brooks PM, March LM. Selection of patients for inpatient rehabilitation or direct home discharge following total joint replacement surgery: A comparison of health status and out-of-pocket expenditure of patients undergoing hip and knee arthroplasty for osteoarthritis. Chronic Illn. 2005;1(4):289–302.

Doig E, Fleming J, Cornwell PL, Kuipers P. Qualitative exploration of a client-centered, goal-directed approach to community-based occupational therapy for adults with traumatic brain injury. Am J Occup Ther. 2009 Sep-Oct;63(5):559-68.

Dow B, Black K, Bremner F, Fearn M. A comparison of a hospital-based and two home-based rehabilitation programmes. Disabil Rehabil. 2007 Apr 30;29(8):635-41.

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Published

2022-02-01

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Research Article

How to Cite

1.
Şahin A, Agar A, Ertürk C. The effect of telerehabilitation on early outcomes in patients undergoing primary total knee replacement: A prospective randomized study. J Surg Med [Internet]. 2022 Feb. 1 [cited 2024 Oct. 30];6(2):139-43. Available from: https://jsurgmed.com/article/view/1035076