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Latest & greatest articles for knee rehabilitation
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on knee rehabilitation or other clinical topics then use Trip today.
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Effects of Virtual Exercise Rehabilitation In-Home Therapy Compared with Traditional Care After Total Knee Arthroplasty: VERITAS, a Randomized Controlled Trial Financial burden for patients, providers, and payers can reduce access to physical therapy (PT) after total knee arthroplasty (TKA). The purpose of the present study was to examine the effect of a virtual PT program on health-care costs and clinical outcomes as compared with traditional care after TKA.At least 10 days before unilateral (...) TKA, patients from 4 clinical sites were enrolled and randomized 1:1 to the virtual PT program (involving an avatar [digitally simulated] coach, in-home 3-dimensional biometrics, and telerehabilitation with remote clinician oversight by a physical therapist) or to traditional PT care in the home or outpatient clinic. The primary outcome was total health-care costs for the 12-week post-hospital period. Secondary (noninferiority) outcomes included 6 and 12-week Knee injury and Osteoarthritis Outcome
Medium-Term Outcomes of Digital Versus Conventional Home-Based Rehabilitation After Total Knee Arthroplasty: Prospective, Parallel-Group Feasibility Study. Physical rehabilitation is recommended after total knee arthroplasty (TKA). With the expected increase in TKA over the next few decades, it is important to find new ways of delivering cost-effective interventions. Technological interventions have been developed with this intent, but only preliminary evidence exists regarding their validity (...) , prospective, parallel-group, feasibility study including an 8-week active treatment stage and further assessments at 3 and 6 months post-TKA. Primary outcome was the Timed Up and Go score, and secondary outcomes were the Knee Osteoarthritis Outcome Scale (KOOS) score and knee range of motion.A total of 59 patients completed the study (30 in the digital intervention group and 29 in the conventional rehabilitation group) and follow-up assessments. During the active treatment stage, patients in the digital
Early self-managed focal sensorimotor rehabilitative training enhances functional mobility and sensorimotor function in patients following total knee replacement: a controlled clinical trial To assess the effects of early self-managed focal sensorimotor training compared to functional exercise training after total knee replacement on functional mobility and sensorimotor function.A single-blind controlled clinical trial.University Hospital of Rion, Greece.A total of 52 participants following (...) for the experimental group over time were represented by a relative effect size range of 1.3-6.5.Overall, the magnitude of improvements in functional mobility and sensorimotor function endorses using focal sensorimotor training as an effective mode of rehabilitation following knee replacement.
Effect of Inpatient Rehabilitation vs a Monitored Home-Based Program on Mobility in Patients With Total Knee Arthroplasty: The HIHO Randomized Clinical Trial. Formal rehabilitation programs, including inpatient programs, are often assumed to optimize recovery among patients after undergoing total knee arthroplasty. However, these programs have not been compared with any outpatient or home-based programs.To determine whether 10 days of inpatient rehabilitation followed by a monitored home-based (...) women, and the cohort had a mean age, 66.9 years (SD, 8.4 years). There was no significant difference in the 6-minute walk test between the inpatient rehabilitation and either of the 2 home program groups (mean difference, -1.01; 95% CI, -25.56 to 23.55), nor in patient-reported pain and function (knee score mean difference, 2.06; 95% CI, -0.59 to 4.71), or quality of life (EQ-5D visual analog scale mean difference, 1.41; 95% CI, -6.42 to 3.60). The number of postdischarge complications
Does the addition of a knee brace, restricting range of movement, provide improved outcomes compared to rehabilitation alone in meniscal repairs? Getting Evidence into Clinical Practice: Musculoskeletal Research Facilitation Group (CAT Group) Date: March 2017 CAT Lead: Lisa Beadle Date CAT completed: March 2017 Lisa.Beadle@uhnm.nhs.uk Date CAT to be reviewed: March 2019 Specific Question: Does the addition of a knee brace, restricting range of movement, provide improved outcomes compared (...) to rehabilitation alone in meniscal repairs? Clinical bottom line There was one small randomised control trial to answer the question posed. As a result of this we are not able to argue in support or against the use of knee braces to restrict range of knee movement as part of the rehabilitation of meniscal repairs post- operatively. We shall therefore continue to follow the post-operative instructions given by each Orthopaedic surgeon in the medical notes for this group of patients. Why is this important
The technique of delivery of peri-operative analgesia does not affect the rehabilitation or outcomes following total knee arthroplasty This non-blinded randomised controlled trial compared the effect of patient-controlled epidural analgesia (PCEA) versus local infiltration analgesia (LIA) within an established enhanced recovery programme on the attainment of discharge criteria and recovery one year after total knee arthroplasty (TKA). The hypothesis was that LIA would increase the proportion (...) = 0.33), mean length of stay (four days in each group, p = 0.540), day of first mobilisation (p = 0.013) or pain (p = 0.278). There was no difference in mean Oxford Knee Scores (41 points in each group, p = 0.915) or the rate of complications in the two groups.Both techniques provided adequate pain relief, enabled early mobilisation and accelerated rehabilitation and good patient-reported outcomes up to one year post-operatively. PCEA and LIA are associated with similar clinical outcomes following
Functional outcomes after surgical management of articular cartilage lesions in the knee: a systematic literature review to guide postoperative rehabilitation Systematic literature review.To systematically review the literature relative to muscle performance, knee joint biomechanics, and performance-based functional outcomes following articular cartilage repair and restoration surgical procedures in the knee.Articular cartilage injuries are associated with functional limitations, poor quality (...) of life, and the potential for long-term disability. This review systematically evaluates evidence related to muscle performance, joint biomechanics, and performance-based functional outcomes following articular cartilage procedures, and discusses their implications for rehabilitation.The online databases of PubMed (MEDLINE), CINAHL, SPORTDiscus, and Scopus were searched (inception to September 2013). Studies pertaining to muscle performance, knee joint biomechanics, and performance-based measures
Update on Physiotherapy Rehabilitation After Total Knee or Hip Replacement Update on physiotherapy rehabilitation after total knee or hip replacement Update on physiotherapy rehabilitation after total knee or hip replacement Ontario Health Technology Advisory Committee Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Ontario Health (...) Technology Advisory Committee. Update on physiotherapy rehabilitation after total knee or hip replacement. Toronto: Health Quality Ontario (HQO). OHTAC Recommendation. 2014 Authors' conclusions OHTAC recommends the health system support the move towards community-based physiotherapy after primary total knee or hip replacement and discharge from acute care. In regards to location of physiotherapy within the community, the health system should allow for flexibility, depending on the local care context
Update on Physiotherapy Rehabilitation After Total Knee or Hip Replacement Update on Physiotherapy Rehabilitation After Total Knee or Hip Replacement: OHTAC Recommendation. March 2014; pp. 1–9 Update on Physiotherapy Rehabilitation After Total Knee or Hip Replacement: OHTAC Recommendation Ontario Health Technology Advisory Committee March 2014 Update on Physiotherapy Rehabilitation After Total Knee or Hip Replacement: OHTAC Recommendation. March 2014; pp. 1–9 Suggested Citation This report (...) should be cited as follows: Ontario Health Technology Advisory Committee (OHTAC). Update on physiotherapy rehabilitation after total knee or hip replacement: OHTAC recommendation [Internet]. Toronto: Queen's Printer for Ontario; 2014 March. 9 p. Available from: http://www.hqontario.ca/evidence/publications-and-ohtac-recommendations/ontario-health- technology-assessment-series/physiotherapy-rehabilitation-after-total-knee-or-hip-replacement. Permission Requests All inquiries regarding permission
Rhona McGlasson Bone and Joint Canada Executive Director Brenda Flaherty Hamilton Health Sciences EVP and Chief Operating Officer Charissa Levy GTA Rehab Network Executive Director Jane DeLacy William Osler Health System Executive Director Clinical Services Kathy Sabo University Health Network Toronto Western Hospital Senior Vice President Executive Head Intensity of Rehabilitation During the Acute Hospitalization Period After Hip or Knee Arthroplasty: A Rapid Review. November 2013; pp. 1–21 15 (...) Intensity of Rehabilitation During the Acute Hospitalization Period After Hip or Knee Arthroplasty Intensity of Rehabilitation During the Acute Hospitalization Period After Hip or Knee Arthroplasty: A Rapid Review. November 2013; pp. 1–21 Intensity of Rehabilitation During the Acute Hospitalization Period After Hip or Knee Arthroplasty: A Rapid Review M Nikitovic November 2013 Evidence Development and Standards Branch at Health Quality Ontario Intensity of Rehabilitation During the Acute
Intensity of Rehabilitation During the Acute Hospitalization Period After Hip or Knee Arthroplasty: A Rapid Review Intensity of rehabilitation during the acute hospitalization period after hip or knee arthroplasty: a rapid review Intensity of rehabilitation during the acute hospitalization period after hip or knee arthroplasty: a rapid review Nikitovic M Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality (...) of this assessment has been made for the HTA database. Citation Nikitovic M. Intensity of rehabilitation during the acute hospitalization period after hip or knee arthroplasty: a rapid review. Toronto: Health Quality Ontario (HQO). Rapid Review. 2013 Authors' objectives The objective of this analysis was to assess the effectiveness of increased intensity of rehabilitation during the acute hospitalization period after primary hip arthroplasty and knee arthroplasty. Authors' conclusions Research Question 1
Accelerated versus nonaccelerated rehabilitation after anterior cruciate ligament reconstruction: a prospective, randomized, double-blind investigation evaluating knee joint laxity using roentgen stereophotogrammetric analysis The relationship between the biomechanical dose of rehabilitation exercises administered after anterior cruciate ligament (ACL) reconstruction and the healing response of the graft and knee is not well understood.After ACL reconstruction, rehabilitation administered (...) with either accelerated or nonaccelerated programs produces the same change in the knees' 6 degrees of freedom, or envelope, laxity values.Randomized controlled trial; Level of evidence, 1.Patients who underwent ACL reconstruction with a bone-patellar tendon-bone autograft were randomized to rehabilitation with either accelerated (19 week) or nonaccelerated (32 week) programs. At the time of surgery, and then 3, 6, 12, and 24 months later, the 6 degrees of freedom knee laxity values were measured using
Does preoperative rehabilitation improve patient-based outcomes in persons who have undergone total knee arthroplasty? A systematic review Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Clinical effectiveness of kneerehabilitation techniques and implications for a self-care treatment model Clinical effectiveness of kneerehabilitation techniques and implications for a self-care treatment model Clinical effectiveness of kneerehabilitation techniques and implications for a self-care treatment model Button K, Iqbal AS, Letchford RH, van Deursen RW CRD summary This review of the effectiveness of kneerehabilitation interventions concluded that most of the existing evidence (...) focused on exercise and showed positive outcomes overall. The authors' conclusion reflects the evidence but may not be reliable due to some limitations in review methods. Authors' objectives To evaluate the clinical effectiveness of kneerehabilitation techniques categorised according to the International Classification of Functioning and Disability (ICF) domains in patients with knee conditions including osteoarthritis, patellofemoral joint pain, acute ligament injuries and postoperative
Benefits of starting rehabilitation within 24 hours of primary total knee arthroplasty: randomized clinical trial To compare the benefits of initiating rehabilitation treatment within 24 hours versus 48-72 hours after total knee arthroplasty for osteoarthritis.Experimental study with clinical trial design.Patients undergoing primary total knee arthroplasty for osteoarthritis were randomly assigned to experimental (n = 153) and control (n = 153) groups.Rehabilitation was started within 24 hours (...) ), greater joint range of motion in flexion (by 16.29 ± 11.39 degrees; P < 0.012) and extension (by 2.12 ± 3.19; P < 0.035), improved strength in quadriceps (by 0.98 ± 0.54; P < 0.042) and hamstring muscles (by 1.05 ± 0.72; P < 0.041), and higher scores for gait (P < 0.047) and balance (P < 0.045).Initiation of rehabilitation within 24 hours after total knee arthroplasty reduces the mean hospital stay and number of sessions required to achieve autonomy and normal gait and balance.
Economic evaluation of multidisciplinary rehabilitation after primary total knee arthroplasty based on a randomized controlled trial To conduct an economic evaluation of a multidisciplinary, biopsychosocial outpatient rehabilitation program implemented 2-4 months after total knee arthroplasty (TKA), compared with conventional orthopedic care.After surgery, 86 patients were randomized to a multidisciplinary rehabilitation group (n = 44) or a conventional orthopedic care group (n = 42). Alongside (...) the randomized controlled trial, we estimated the costs of rehabilitation, health care resource use, and community support. Information about resource use was collected by means of a questionnaire together with data from hospital records. The primary outcome (effectiveness) measure was change in self-reported functional capacity and the secondary measure was quality-adjusted life years (QALYs) gained during the 12-month followup. Cost-effectiveness was assessed from between-group differences in costs, change
Postoperative analgesia and early rehabilitation after total knee replacement: a comparison of continuous low-dose intravenous ketamine versus nefopam The effects of nefopam and ketamine on pain control and rehabilitation after total knee replacement were compared in a prospective, double blinded study. Seventy-five patients were randomly assigned to receive a 0.2mg kg(-1) bolus of nefopam or ketamine, followed by a 120microg kg(-1) h(-1) continuous infusion until the end of surgery (...) , and 60microg kg(-1) h(-1) until the second postoperative day, or an equal volume of saline considered as placebo. Pain scores measured on a visual analog scale at rest and on mobilization, and patient-controlled intravenous morphine consumption, were assessed during 48h. We measured the maximal knee flexion on the third postoperative day, and the delay to obtain a 90 degrees flexion. Ketamine and nefopam reduced morphine consumption (p<0.0001). Pain scores, were lower at rest and on mobilization
Cost-effectiveness of accelerated perioperative care and rehabilitation after total hip and knee arthroplasty Accelerated perioperative rehabilitation protocols following total hip and knee arthroplasties are currently being implemented worldwide, but the cost-effectiveness of these protocols from a societal perspective is not known. We compared the cost-effectiveness of an accelerated perioperative care and rehabilitation protocol with that of a more standard protocol for patients treated (...) with total hip and knee arthroplasty.A cost-effectiveness study was undertaken as a study piggybacked on a randomized clinical trial comparing early outcomes of an accelerated and intensive postoperative rehabilitation regimen with those of a more standard rehabilitation protocol. We assessed eighty-seven patients (forty-two who received the standard protocol and forty-five who received the accelerated protocol) for a total of twelve months. Costs from the time of the patient's visit immediately before