title: Group rehabilitation versus individual rehabilitation following knee and hip replacement: a pilot study with randomized, single-blind, cross-over design.
abstract: BACKGROUND
  In recent years a vast literature has been dedicated to cost effectiveness analysis. In the rehabilitation field, the search for less costly forms of treatment is an area under intense discussion by the rehabilitation scientific community. Group rehabilitation programs for some pathological conditions could permit better allocation of economic resources, but few studies evaluated the efficacy of group physiotherapy as opposed to individual physiotherapy.
  
  
  OBJECTIVE
  The purpose of this study is to compare the effects of group rehabilitation (GrpR) with individual rehabilitation (IndR) for inpatients that have undergone knee and hip replacement. Design. This is a pilot study with randomized, single-blind, cross-over design.
  
  
  METHODS
  Inpatients Physiotherapy Department of Don Gnocchi Foundation.
  
  
  METHODS
  Clinical disability evaluation (JOASH, IKS, DI) and patient-oriented assessment (SF-36, WOMAC and VAS) were performed on 27 patients undergoing a physical therapy program after knee or hip replacement. Patients having partial weight-bearing postoperatively (about 50% of the total) and a range of motion >50% of the total in the joint replaced were included and then randomized (T0) in two intervention programs: GrpR/IndR - who performed GrpR for 15 days (T1), followed by the IndR for 15 days (T2); and IndR/GrpR - who performed the IndR for 15 days (T1), followed by GrpR for 15 days (T2).
  
  
  RESULTS
  Comparing the changes from baseline T1-T0 and T2-T1 separately in the two groups most outcomes showed no significant difference.
  
  
  CONCLUSIONS
  This pilot trial suggests that the group rehabilitation program is just as efficient as the individual rehabilitation for inpatients that have undergone knee and hip replacement and are able to weight-bear postoperatively. A potential benefit of group-based therapy is that it is less resource intensive.
authors.affiliation: Don Carlo Gnocchi Onlus Foundation, Rome, Italy. iaprile@dongnocchi.it
authors.forename: I
authors.initials: I
authors.lastname: Aprile
authors.forename: R S
authors.initials: RS
authors.lastname: Rizzo
authors.forename: E
authors.initials: E
authors.lastname: Romanini
authors.forename: F
authors.initials: F
authors.lastname: De Santis
authors.forename: S
authors.initials: S
authors.lastname: Marsan
authors.forename: G
authors.initials: G
authors.lastname: Rinaldi
authors.forename: L
authors.initials: L
authors.lastname: Padua
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000534:rehabilitation*; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D003362:Cost-Benefit Analysis; D018592:Cross-Over Studies; D005260:Female; D006126:Group Processes; D006801:Humans; D007297:Inpatients; D007558:Italy; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D010147:Pain Measurement; D017060:Patient Satisfaction; D010814:Physical Therapy Department, Hospital / Q000191:economics* / Q000458:organization & administration; D026741:Physical Therapy Modalities / Q000191:economics* / Q000458:organization & administration; D010865:Pilot Projects; D016059:Range of Motion, Articular; D018709:Statistics, Nonparametric