title: Measuring functional performance at discharge from hospital after total joint arthroplasty as a pre-requisite for planning early rehabilitation: a prognostic study.
abstract: BACKGROUND
  The autonomy achieved by discharge after total knee and hip arthroplasty is important for planning early rehabilitation.
  
  
  OBJECTIVE
  Describe functional performance using the Iowa Level of Assistance (ILOA) scale and investigate possible prognostic factors.
  
  
  METHODS
  A prospective cohort study design was used. Autonomy at discharge was measured using the ILOA scale. Postoperative factors such as time to remove surgical drains, the length of hospitalization, preoperative physical therapy, and the number of physiotherapy treatments were collected.
  
  
  RESULTS
  The sample was composed of 452 patients: 191 men (42.3%) and 261 women (57.7%). The mean ILOA score was 12.34 (SD = 5.4), representing a level of autonomy of 68.4%. Gait speed was the activity with the highest score and it ranged from 0.26 m/s to 0.32 m/s. Based on univariate and multivariate analysis, gender and age were the only significant variables to influence achieving autonomy at discharge.
  
  
  CONCLUSIONS
  The rehabilitative program in its acute phase should be planned with particular attention paid to elderly women, unifying the physiotherapy protocol for total hip arthroplasty (THA) and total knee arthroplasty (TKA), reviewing the modalities of preoperative treatment sessions and with a specific training for the speed gait.
authors.affiliation: Mattia Morri, PhT, Physiotherapist Researcher, Department of Physical Therapy and Rehabilitation, Istituto Ortopedico Rizzoli, Italy (via Pupilli 1, 40136 Bologna). Natalia Franchini, PhT, Physiotherapist, Department of Physical Therapy and Rehabilitation, Istituto Ortopedico Rizzoli, Italy (via Pupilli 1, 40136 Bologna). Graziella Gerini, PhT, Physiotherapist, Department of Physical Therapy and Rehabilitation, Istituto Ortopedico Rizzoli, Italy (via Pupilli 1, 40136 Bologna). Rosalba Morabito, PhT, Physiotherapist, Department of Physical Therapy and Rehabilitation, Istituto Ortopedico Rizzoli, Italy (via Pupilli 1, 40136 Bologna). Elettra Pignotti, PhD, Statistician, Department of Nursing and Allied Health Professions, Istituto Ortopedico Rizzoli, Italy (via Pupilli 1, 40136 Bologna). Maria Grazia Benedetti, MD, Medical Director, Department of Physical Therapy and Rehabilitation, Istituto Ortopedico Rizzoli, Italy (via Pupilli 1, 40136 Bologna). Ornella Marchese, PhT, Physiotherapist, Department of Physical Therapy and Rehabilitation, Istituto Ortopedico Rizzoli, Italy (via Pupilli 1, 40136 Bologna). Enrichetta Zanotti, RN, Director of Department of Nursing and Allied Health Professions, Istituto Ortopedico Rizzoli, Italy (via Pupilli 1, 40136 Bologna).
authors.forename: Mattia
authors.initials: M
authors.lastname: Morri
authors.forename: Natalia
authors.initials: N
authors.lastname: Franchini
authors.forename: Graziella
authors.initials: G
authors.lastname: Gerini
authors.forename: Rosalba
authors.initials: R
authors.lastname: Morabito
authors.forename: Elettra
authors.initials: E
authors.lastname: Pignotti
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Benedetti
authors.forename: Ornella
authors.initials: O
authors.lastname: Marchese
authors.forename: Enrichetta
authors.initials: E
authors.lastname: Zanotti
mesh_terms: D000328:Adult; D032722:Advance Care Planning; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000534:rehabilitation*; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D057187:Independent Living; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D026684:Personal Autonomy; D011379:Prognosis; D011446:Prospective Studies; D055815:Young Adult