Active physiotherapy interventions following total knee arthroplasty in the hospital and inpatient rehabilitation settings: a systematic review and meta-analysis

Physiotherapy is a routine component of postoperative management following total knee arthroplasty (TKA). As the demand for surgery increases it is vital that postoperative physiotherapy interventions are effective and efficient. Determine the most beneficial active physiotherapy interventions in ac...

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Vydané v:Physiotherapy Ročník 104; číslo 1; s. 25 - 35
Hlavní autori: Henderson, Kate G., Wallis, Jason A., Snowdon, David A.
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: England Elsevier Ltd 01.03.2018
Predmet:
Arthroplasty, Replacement, Knee - rehabilitation
Exercise Therapy - methods
Humans
Hydrotherapy
Hydrotherapy - methods
Inpatients
Movement
Pain - rehabilitation
Physical Medicine and Rehabilitation
Physical Therapy Modalities
Physiotherapy specialty
Physiotherapy techniques
Postoperative Care
Randomized Controlled Trials as Topic
Range of Motion, Articular
Rehabilitation
Total knee arthroplasty
Physiotherapy specialty
Total knee arthroplasty
Hydrotherapy
Rehabilitation
Physiotherapy techniques
rehabilitation
physiotherapy techniques
physiotherapy specialty
hydrotherapy
ISSN:0031-9406, 1873-1465, 1873-1465
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Shrnutí:Physiotherapy is a routine component of postoperative management following total knee arthroplasty (TKA). As the demand for surgery increases it is vital that postoperative physiotherapy interventions are effective and efficient. Determine the most beneficial active physiotherapy interventions in acute hospital and inpatient rehabilitation for improving pain, activity, range of motion and reducing length of stay for adults who have undergone TKA. Electronic databases MEDLINE, CINAHL, PUBMED and EMBASE. Randomised controlled trials investigating the effect of active physiotherapy interventions in the acute hospital or inpatient rehabilitation setting for adults who have undergone TKA. Risk of bias for individual studies was assessed using the Physiotherapy Evidence Database (PEDro) scale. Standardised Mean Differences (SMD) or Mean Differences (MD) and 95% confidence intervals were calculated and combined in meta-analyses. Quality of meta-analyses was assessed using the Grades of Research, Assessment, Development and Evaluation approach. Accelerated physiotherapy regimens were effective for reducing acute hospital length of stay (MD −3.50 days, 95% CI −5.70 to −1.30). Technology-assisted physiotherapy did not show any difference for activity (SMD −0.34, 95% CI −0.82 to 0.13). From high quality individual studies pain, activity and range of motion improved with accelerated physiotherapy regimens and activity improved with hydrotherapy. Lack of blinding and small sample sizes across the included trials. After TKA, there is low level evidence that accelerated physiotherapy regimens can reduce acute hospital length of stay. Systematic review registration number PROSPERO (Registration number CRD42014013414) http://www.crd.york.ac.uk/PROSPERO.
Bibliografia:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
ObjectType-Review-3
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ISSN:0031-9406
1873-1465
1873-1465
DOI:10.1016/j.physio.2017.01.002