Warren Meghan, Kozik Jennifer, Cook Jon, Prefontaine Paul, Ganley Kathleen
Meghan Warren, PhD, MPH, PT, Associate Professor, Department of Physical Therapy and Athletic Training, Northern Arizona University, Flagstaff, AZ. Jennifer Kozik, PT, Physical Therapist, Therapy Services, University of Arizona Medical Center, Tucson, AZ. Jon Cook, PT, Physical Therapist, Northern Arizona Healthcare, Cottonwood, AZ. Paul Prefontaine, PT, Director of Rehabilitation, Northern Arizona Healthcare, Cottonwood, AZ. Kathleen Ganley, PhD, PT, Associate Professor, Department of Physical Therapy and Athletic Training, Northern Arizona University, Phoenix, AZ.
Orthop Nurs. 2016 Nov/Dec;35(6):382-390. doi: 10.1097/NOR.0000000000000295.
Rehabilitation outcomes for patients with total knee arthroplasty (TKA) after hospital discharge are not well understood.
The purpose of this retrospective cohort study was to describe outpatient physical therapy (PT) after TKA and compare short-term (2 months) functional and clinical outcomes of patients following TKA who were discharged from the hospital to home and received (a) outpatient PT immediately (OP) or (b) home health PT before outpatient PT (HH).
The medical records of 109 men and women postoperative TKA discharged home were abstracted for the 6-minute walk test (6MWT), Knee Osteoarthritis and Outcome Score (KOOS), and knee range of motion (ROM) preoperatively and after discharge from all postoperative PT. Patients received outpatient clinic-based PT immediately after discharge from the hospital (OP) (n = 87) or home health PT before continued rehabilitation in an outpatient setting (HH) (n = 22).
Despite demographic differences between OP and HH preoperatively, adjusted models revealed no significant differences among KOOS, 6MWT, or knee ROM between OP and HH upon completion of postoperative PT. Patients in OP completed PT on average 20 days sooner (p = .0007), although the amount of time in outpatient PT (p = .55) and the number of outpatient PT visits (p = .68) were similar between groups.
Gains in function were achieved by patients in OP and HH independent of the postoperative PT setting, although OP achieved gains sooner.
全膝关节置换术（TKA）患者出院后的康复效果尚未得到充分了解。
这项回顾性队列研究的目的是描述TKA后的门诊物理治疗（PT），并比较从医院出院回家且接受（a）立即门诊PT（OP）或（b）门诊PT前接受家庭健康PT（HH）的TKA患者的短期（2个月）功能和临床结局。
提取109例TKA术后出院回家的男性和女性的病历，记录术前以及所有术后PT出院后的6分钟步行试验（6MWT）、膝关节骨关节炎和结局评分（KOOS）以及膝关节活动范围（ROM）。患者在出院后立即接受门诊PT（OP）（n = 87）或在门诊继续康复前接受家庭健康PT（HH）（n = 22）。
尽管术前OP组和HH组在人口统计学上存在差异，但校正模型显示术后PT完成时，OP组和HH组在KOOS、6MWT或膝关节ROM方面无显著差异。OP组患者平均提前20天完成PT（p = .0007），尽管两组门诊PT的时间（p = .55）和门诊PT就诊次数（p = .68）相似。
OP组和HH组患者均实现了功能改善，且与术后PT设置无关，尽管OP组实现改善的时间更早。
