Clinical effectiveness of a standardized community-based supervised post-acute rehabilitation model after total knee arthropathy: A pilot study.

BACKGROUND

Hospital-based outpatient physiotherapy is the standard of care for subacute rehabilitation after total knee arthroplasty (TKA) in Singapore. This study explores the clinical effectiveness of a standardized rehabilitation model at community-based rehabilitation centers to align the appropriate utilization of tertiary and community rehabilitative resources.

METHODS

In this pilot study, patients who had undergone TKA were assigned to either control group (n=30) or to intervention group (n=29). The control group received usual hospital-based outpatient physiotherapy, while the intervention group received rehabilitation at a community-based rehabilitation center based on standardized institution protocol. Primary and secondary outcomes were assessed at baseline and at 3 months post TKA.

RESULTS

Baseline characteristics in both groups were not significantly different. All patients completed the study. At 3 months, there were no significant differences in the Time Up and Go test (<0.853), median 30 s chair rise (=0.347), knee flexion passive range of motion (=0.933), knee extension passive range of motion (=0.409), and presence of knee extension lag (=0.360). There was a lower pain intensity in the intervention group compared with the control group (=0.003).

CONCLUSIONS

A community-based post-acute TKA rehabilitative model demonstrated improvements in functional outcomes, and reduced pain intensity in study participants, with these findings being similar to that of standard of care hospital-based outpatient physiotherapy. This model of care warrants further evaluation in larger clinical trials.