Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, 1081 BT Amsterdam, The Netherlands.
Coronel Institute of Occupational Health, Amsterdam UMC, Academic Medical Center, Amsterdam Public Health Research Institute, 1105 AZ Amsterdam, The Netherlands.
Int J Environ Res Public Health. 2020 Jul 9;17(14):4952. doi: 10.3390/ijerph17144952.
Evidence for recommendations concerning the resumption of activities of daily life, including work and sport, after knee arthroplasty is lacking. Therefore, recommendations vary considerably between hospitals and healthcare professionals. We aimed to obtain multidisciplinary consensus for such recommendations. Using a Delphi procedure, we strived to reach consensus among a multidisciplinary expert panel of six orthopaedic surgeons, three physical therapists, five occupational physicians and one physician assistant on recommendations regarding the resumption of 27 activities of daily life. The Delphi procedure involved three online questionnaire rounds and one face-to-face consensus meeting. In each of these four rounds, experts independently decided at what time daily life activities could feasibly and safely be resumed after knee arthroplasty. We distinguished patients with a fast, average and slow recovery. After four Delphi rounds, the expert panel reached consensus for all 27 activities. For example, experts agreed that total knee arthroplasty patients with a fast recovery could resume cycling six weeks after the surgery, while those with an average and slow recovery could resume this activity after nine and twelve weeks, respectively. The consensus recommendations will subsequently be integrated into an algorithm of a personalized m/eHealth portal to enhance recovery among knee arthroplasty patients.
关于膝关节置换术后恢复日常生活活动（包括工作和运动）的建议缺乏证据。因此，不同医院和医疗保健专业人员之间的建议差异很大。我们旨在为这些建议达成多学科共识。我们使用 Delphi 程序，努力在六名骨科医生、三名物理治疗师、五名职业医生和一名医师助理组成的多学科专家小组中达成共识，就 27 项日常生活活动的恢复提出建议。Delphi 程序涉及三轮在线问卷和一轮面对面共识会议。在这四轮中的每一轮，专家们都独立决定膝关节置换术后患者在什么时间可以安全、可行地恢复日常生活活动。我们区分了恢复较快、平均和较慢的患者。四轮 Delphi 后，专家组就所有 27 项活动达成共识。例如，专家们一致认为，恢复较快的全膝关节置换术患者可以在手术后六周开始骑自行车，而恢复平均和较慢的患者可以分别在九周和十二周后开始这项活动。共识建议随后将整合到个性化 m/eHealth 门户的算法中，以增强膝关节置换术患者的康复效果。
