TITLE

Internet-Based Outpatient Telerehabilitation for Patients Following Total Knee Arthroplasty

AUTHOR(S)
Russell, Trevor G.; Buttrum, Peter; Wootton, Richard; Jull, Gwendolen A.
PUB. DATE
January 2011
SOURCE
Journal of Bone & Joint Surgery, American Volume;1/19/2011, Vol. 93-A Issue 2, p113
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Total knee arthroplasty is an effective means for relieving the symptoms associated with degenerative arthritis of the knee. Rehabilitation is a necessary adjunct to surgery and is important in regaining optimum function. Access to high-quality rehabilitation services is not always possible, especially forthose who live in rural or remote areas. The aim of this study was to evaluate the equivalence of an Internet-based telerehabilitation program compared with conventional outpatient physical therapy for patients who have had a total knee arthroplasty. Methods: This investigation was a single-blinded, prospective, randomized, control led noni nferiority trial. Sixty-five participants were randomized to receive a six-week program of outpatient physical therapy either in the conventional manner or by means of an Internet-based telerehabilitation program. The primary outcome measure was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) measured at baseline and six weeks by a blinded independent assessor. Secondary outcomes included the Patient-Specific Functional Scale, the timed up-and-go test, pain intensity, knee flexion and extension, quadriceps muscle strength, limb girth measurements, and an assessment of gait. Noninferiority was assessed through the comparison of group differences with a noninferiority margin and with linear mixed model statistics. Results: Baseline characteristics between groups were similar, and all participants had significant improvement on all outcome measures with the intervention (p < 0.01 for alI)~ After the six-week intervention, participants in the tele-rehabilitation group achieved outcomes comparable to those of the conventional rehabilitation group with regard to flexion and extension range of motion, muscle strength, limb girth, pain, timed up-and-go test, quality of life, and clinical gait and WOMAC scores. Better outcomes for the Patient-Specific Functional Scale and the stiffness subscale of the WOMAC were found in the telerehabilitation group (p <0.05). The telerehabilitation intervention was well received by participants, who reported a high level of satisfaction with this novel technology. Conclusions: The outcomes achieved via telerehabilitation at six weeks following total knee arthroplasty were comparable with those after conventional rehabilitation.
ACCESSION #
57567660

 

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