title: Comparison of group-based outpatient physiotherapy with usual care after total knee replacement: a feasibility study for a randomized controlled trial.
abstract: OBJECTIVE
  To evaluate the feasibility of conducting a randomized controlled trial comparing group-based outpatient physiotherapy with usual care in patients following total knee replacement.
  
  
  METHODS
  A feasibility study for a randomized controlled trial.
  
  
  METHODS
  One secondary-care hospital orthopaedic centre, Bristol, UK.
  
  
  METHODS
  A total of 46 participants undergoing primary total knee replacement.
  
  
  METHODS
  The intervention group were offered six group-based exercise sessions after surgery. The usual care group received standard postoperative care. Participants were not blinded to group allocation.
  
  
  METHODS
  Feasibility was assessed by recruitment, reasons for non-participation, attendance, and completion rates of study questionnaires that included the Lower Extremity Functional Scale and Knee Injury and Osteoarthritis Outcome Score.
  
  
  RESULTS
  Recruitment rate was 37%. Five patients withdrew or were no longer eligible to participate. Intervention attendance was high (73%) and 84% of group participants reported they were 'very satisfied' with the exercises. Return of study questionnaires at six months was lower in the usual care (75%) than in the intervention group (100%). Mean (standard deviation) Lower Extremity Functional Scale scores at six months were 45.0 (20.8) in the usual care and 57.8 (15.2) in the intervention groups.
  
  
  CONCLUSIONS
  Recruitment and retention of participants in this feasibility study was good. Group-based physiotherapy was acceptable to participants. Questionnaire return rates were lower in the usual care group, but might be enhanced by telephone follow-up. The Lower Extremity Functional Scale had high responsiveness and completion rates. Using this outcome measure, 256 participants would be required in a full-scale randomized controlled trial.
authors.affiliation: 1 Institute of Sport and Exercise Science, University of Worcester, Worcester, UK.
authors.forename: Neil
authors.initials: N
authors.lastname: Artz
authors.affiliation: 2 Musculoskeletal Research Unit, University of Bristol, Bristol, UK.
authors.forename: Samantha
authors.initials: S
authors.lastname: Dixon
authors.affiliation: 2 Musculoskeletal Research Unit, University of Bristol, Bristol, UK.
authors.forename: Vikki
authors.initials: V
authors.lastname: Wylde
authors.affiliation: 3 School of Social and Community Medicine, University of Bristol, Bristol, UK.
authors.forename: Elsa
authors.initials: E
authors.lastname: Marques
authors.affiliation: 2 Musculoskeletal Research Unit, University of Bristol, Bristol, UK.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Beswick
authors.affiliation: 2 Musculoskeletal Research Unit, University of Bristol, Bristol, UK.
authors.forename: Erik
authors.initials: E
authors.lastname: Lenguerrand
authors.affiliation: 2 Musculoskeletal Research Unit, University of Bristol, Bristol, UK.
authors.forename: Ashley W
authors.initials: AW
authors.lastname: Blom
authors.affiliation: 2 Musculoskeletal Research Unit, University of Bristol, Bristol, UK.
authors.forename: Rachael
authors.initials: R
authors.lastname: Gooberman-Hill
mesh_terms: D000368:Aged; D000553:Ambulatory Care; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D004739:England; D005081:Exercise Therapy / Q000379:methods* / Q000458:organization & administration; D005240:Feasibility Studies; D005260:Female; D006126:Group Processes; D006801:Humans; D008297:Male; D010043:Outcome and Process Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data*; D000071066:Patient Reported Outcome Measures; D010865:Pilot Projects
keywords: Group-based exercise; feasibility; randomized controlled trial; total knee replacement