title: Comparison of clinic- and home-based rehabilitation programs after total knee arthroplasty.
abstract: One hundred sixty patients (mean age, 68 +/- 8 years) having primary total knee arthroplasty were assigned randomly to two rehabilitation programs: (1) clinic-based rehabilitation provided by outpatient physical therapists; or (2) home-based rehabilitation monitored by periodic telephone calls from a physical therapist. Both rehabilitation programs emphasized a common home exercise program. Before surgery, and at 12 and 52 weeks after surgery, no statistically significant differences were observed between the clinic- and the home-based groups on any of the following measures: (1) total score on the Knee Society clinical rating scale; (2) total score on the Western Ontario and McMaster Universities Osteoarthritis Index; (3) total score on the Medical Outcomes Study Short Form; (4) pain scale of the Knee Society clinical rating scale; (5) pain scale of the Western Ontario and McMaster Universities Osteoarthritis Index; (6) functional scale of the Western Ontario and McMaster Universities Osteoarthritis Index; (7) distance walked in 6 minutes; (8) number of stairs ascended and descended in 30 seconds; and (9) knee flexion range of motion, on either the per protocol or the intent-to-treat or the analyses. After primary total knee arthroplasty, patients who completed a home exercise program (home-based rehabilitation) performed similarly to patients who completed regular outpatient clinic sessions in addition to the home exercises (clinic-based rehabilitation). Additional studies need to determine which patients are likely to benefit most from clinic-based rehabilitation programs.
authors.affiliation: School of Physical Therapy, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada. jkramer@uwo.ca
authors.forename: John F
authors.initials: JF
authors.lastname: Kramer
authors.forename: Mark
authors.initials: M
authors.lastname: Speechley
authors.forename: Robert
authors.initials: R
authors.lastname: Bourne
authors.forename: Cecil
authors.initials: C
authors.lastname: Rorabeck
authors.forename: Margaret
authors.initials: M
authors.lastname: Vaz
mesh_terms: D000368:Aged; D000553:Ambulatory Care; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D002170:Canada; D005081:Exercise Therapy / Q000379:methods; D006302:Health Services Research; D018575:Home Care Services, Hospital-Based / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D010814:Physical Therapy Department, Hospital / Q000706:statistics & numerical data*; D016896:Treatment Outcome