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Effect of group-based outpatient physical therapy on function after total knee replacement: Results from a multicenter randomized controlled trial

Lenguerrand, Erik; Artz, Neil; Marques, Elsa; Gooberman-Hill, Rachael; Sanderson, Emily; Lewis, Kristina; Murray, James; Parwez, Tarique; Bertram, Wendy; Beswick, Andrew D.; Burston, Amanda; Gooberman‐Hill, Rachael; Blom, Ashley W.; Wylde, Vikki

Effect of group-based outpatient physical therapy on function after total knee replacement: Results from a multicenter randomized controlled trial Thumbnail


Authors

Erik Lenguerrand

Elsa Marques

Rachael Gooberman-Hill

Emily Sanderson

Kristina Lewis

James Murray

Tarique Parwez

Wendy Bertram

Andrew D. Beswick

Amanda Burston

Rachael Gooberman‐Hill

Ashley W. Blom

Vikki Wylde



Abstract

Arthritis Care & Research published by Wiley Periodicals, Inc. on behalf of American College of Rheumatology. Objective: To evaluate the long-term clinical effectiveness of a novel group-based outpatient physical therapy (PT) following total knee replacement (TKR). Methods: In this 2-center, unblinded, superiority, randomized controlled trial, 180 patients on a waiting list for primary TKR due to osteoarthritis were randomized to a 6 session group-based outpatient PT intervention and usual care (n = 89) or usual care alone (n = 91). The primary outcome was patient-reported functional ability measured by the Lower Extremity Functional Scale at 12 months postoperative. Secondary outcomes included knee symptoms, depression, anxiety, and satisfaction. Questionnaires were completed preoperatively and at 3, 6, and 12 months postoperatively. Results: The mean difference in function between groups was 4.47 (95% confidence interval [95% CI] 0.20, 8.75; P = 0.04) at 12 months postoperative, favoring the intervention. The mean difference in function between groups decreased over time, from 8.1 points at 3 months (95% CI 3.8, 12.4; P < 0.001) to 5.4 (95% CI 1.1, 9.8; P = 0.015) at 6 months postoperative. There were no clinically relevant differences in any secondary outcomes between groups, although patients in the intervention group were more likely to be satisfied with their PT. No serious adverse events related to the intervention were reported. Conclusion: Supplementing usual care with this group-based outpatient PT intervention led to improvements in function at 12 months after TKR, although the magnitude of the difference was below the minimum clinically important difference of 9 points. However, patient satisfaction was higher in the intervention group, and there was some evidence of clinically relevant improvements in function at 3 months.

Journal Article Type Article
Publication Date May 28, 2020
Journal Arthritis Care & Research
Print ISSN 2151-464X
Electronic ISSN 2151-4658
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 72
Issue 6
Pages 768-777
APA6 Citation Gooberman-Hill, R., Wylde, V., Lenguerrand, E., Gooberman‐Hill, R., Artz, N., Marques, E., …Blom, A. W. (2020). Effect of group-based outpatient physical therapy on function after total knee replacement: Results from a multicenter randomized controlled trial. Arthritis Care and Research, 72(6), 768-777. https://doi.org/10.1002/acr.23909
DOI https://doi.org/10.1002/acr.23909
Keywords Knee replacement, physiotherapy, function, pain, satisfaction
Publisher URL https://onlinelibrary.wiley.com/doi/10.1002/acr.23909

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Effect of Group‐Based Outpatient Physical Therapy on Function After Total Knee Replacement: Results From a Multicenter Randomized Controlled Trial (511 Kb)
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Copyright Statement
© 2019 The Authors. Arthritis Care & Research published by Wiley Periodicals, Inc. on behalf of American College of Rheumatology.

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.







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