The effect of a digital-assisted group rehabilitation on clinical and functional outcomes after total hip and knee arthroplasty—a prospective randomized controlled pilot study
Abstract Background The rising number of total hip and knee arthroplasties and the decreasing availability of physiotherapists require clinically and economically effective rehabilitation approaches. Therefore, the present pilot study investigated the effect of a novel digital-assisted individualize...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-023-06270-8 |
| _version_ | 1797865831621722112 |
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| author | Judith Osterloh Franziska Knaack Rainer Bader Martin Behrens Juliana Peschers Lisa Nawrath Philipp Bergschmidt Martin Darowski |
| author_facet | Judith Osterloh Franziska Knaack Rainer Bader Martin Behrens Juliana Peschers Lisa Nawrath Philipp Bergschmidt Martin Darowski |
| author_sort | Judith Osterloh |
| collection | DOAJ |
| description | Abstract Background The rising number of total hip and knee arthroplasties and the decreasing availability of physiotherapists require clinically and economically effective rehabilitation approaches. Therefore, the present pilot study investigated the effect of a novel digital-assisted individualized group rehabilitation program on clinical and functional outcomes after total hip and knee arthroplasty. Methods In this randomized controlled pilot study, 26 patients undergoing total knee or hip replacement were randomly assigned to either the intervention group (IG, novel digital-assisted group therapy) or the control group (CG, standard postoperative physiotherapy currently carried out in Germany). The IG received the novel digital-assisted group therapy twice per week for a six-months period, while the CG received individual outpatient therapy depending on the prescription of the supervising physician. The number of therapy sessions was recorded. Moreover, subjective outcomes (EuroQol-5Dimensions (EQ-5D) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)), functional outcome (30 s sit to stand test and timed up and go test (TUG)), as well as gait parameters were quantified preoperatively as well as at three and six months after surgery. Data were analyzed using an analysis of covariance with baseline-adjustment. Results No patient-reported falls, pain, and hospital readmissions were recorded. On average, the IG received more therapy sessions. The clinical and functional outcomes were mainly not significantly different between groups at three- and six-months follow-up, but medium to large effect sizes for the differences in quality of life (EQ-5D) as well as pain, stiffness, and physical function (WOMAC), and TUG performance were observed in favor of the IG. However, the IG showed a higher variability of gait velocity after total joint replacement. Conclusion The digital-assisted rehabilitation had positive effects on quality of life, pain, stiffness, physical function, and TUG performance. Nevertheless, the therapy concept may be improved by adding exercises focusing on gait performance to reduce gait variability. The results indicate that the digital-assisted therapy concept is effective and safe. Therefore, a consecutive full-scaled randomized controlled clinical trial is recommended. Trial registration This study was retrospectively registered on 14/02/2022 in the German Clinical Trial Register (DRKS00027960). |
| first_indexed | 2024-04-09T23:15:18Z |
| format | Article |
| id | doaj.art-5e9255ee7dd94fccb38cb2fabdd6c9d5 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-04-09T23:15:18Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-5e9255ee7dd94fccb38cb2fabdd6c9d52023-03-22T10:03:07ZengBMCBMC Musculoskeletal Disorders1471-24742023-03-0124111110.1186/s12891-023-06270-8The effect of a digital-assisted group rehabilitation on clinical and functional outcomes after total hip and knee arthroplasty—a prospective randomized controlled pilot studyJudith Osterloh0Franziska Knaack1Rainer Bader2Martin Behrens3Juliana Peschers4Lisa Nawrath5Philipp Bergschmidt6Martin Darowski7Department of Orthopaedics, Rostock University Medical CenterDepartment of Orthopaedics, Rostock University Medical CenterDepartment of Orthopaedics, Rostock University Medical CenterDepartment of Orthopaedics, Rostock University Medical CenterVital & Physio GmbHVital & Physio GmbHDepartment of Orthopaedics, Rostock University Medical CenterDepartment of Orthopaedics, Rostock University Medical CenterAbstract Background The rising number of total hip and knee arthroplasties and the decreasing availability of physiotherapists require clinically and economically effective rehabilitation approaches. Therefore, the present pilot study investigated the effect of a novel digital-assisted individualized group rehabilitation program on clinical and functional outcomes after total hip and knee arthroplasty. Methods In this randomized controlled pilot study, 26 patients undergoing total knee or hip replacement were randomly assigned to either the intervention group (IG, novel digital-assisted group therapy) or the control group (CG, standard postoperative physiotherapy currently carried out in Germany). The IG received the novel digital-assisted group therapy twice per week for a six-months period, while the CG received individual outpatient therapy depending on the prescription of the supervising physician. The number of therapy sessions was recorded. Moreover, subjective outcomes (EuroQol-5Dimensions (EQ-5D) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)), functional outcome (30 s sit to stand test and timed up and go test (TUG)), as well as gait parameters were quantified preoperatively as well as at three and six months after surgery. Data were analyzed using an analysis of covariance with baseline-adjustment. Results No patient-reported falls, pain, and hospital readmissions were recorded. On average, the IG received more therapy sessions. The clinical and functional outcomes were mainly not significantly different between groups at three- and six-months follow-up, but medium to large effect sizes for the differences in quality of life (EQ-5D) as well as pain, stiffness, and physical function (WOMAC), and TUG performance were observed in favor of the IG. However, the IG showed a higher variability of gait velocity after total joint replacement. Conclusion The digital-assisted rehabilitation had positive effects on quality of life, pain, stiffness, physical function, and TUG performance. Nevertheless, the therapy concept may be improved by adding exercises focusing on gait performance to reduce gait variability. The results indicate that the digital-assisted therapy concept is effective and safe. Therefore, a consecutive full-scaled randomized controlled clinical trial is recommended. Trial registration This study was retrospectively registered on 14/02/2022 in the German Clinical Trial Register (DRKS00027960).https://doi.org/10.1186/s12891-023-06270-8Total knee replacementTotal hip replacementEndoprosthesisPostoperative rehabilitationPhysiotherapyDigitalization |
| spellingShingle | Judith Osterloh Franziska Knaack Rainer Bader Martin Behrens Juliana Peschers Lisa Nawrath Philipp Bergschmidt Martin Darowski The effect of a digital-assisted group rehabilitation on clinical and functional outcomes after total hip and knee arthroplasty—a prospective randomized controlled pilot study BMC Musculoskeletal Disorders Total knee replacement Total hip replacement Endoprosthesis Postoperative rehabilitation Physiotherapy Digitalization |
| title | The effect of a digital-assisted group rehabilitation on clinical and functional outcomes after total hip and knee arthroplasty—a prospective randomized controlled pilot study |
| title_full | The effect of a digital-assisted group rehabilitation on clinical and functional outcomes after total hip and knee arthroplasty—a prospective randomized controlled pilot study |
| title_fullStr | The effect of a digital-assisted group rehabilitation on clinical and functional outcomes after total hip and knee arthroplasty—a prospective randomized controlled pilot study |
| title_full_unstemmed | The effect of a digital-assisted group rehabilitation on clinical and functional outcomes after total hip and knee arthroplasty—a prospective randomized controlled pilot study |
| title_short | The effect of a digital-assisted group rehabilitation on clinical and functional outcomes after total hip and knee arthroplasty—a prospective randomized controlled pilot study |
| title_sort | effect of a digital assisted group rehabilitation on clinical and functional outcomes after total hip and knee arthroplasty a prospective randomized controlled pilot study |
| topic | Total knee replacement Total hip replacement Endoprosthesis Postoperative rehabilitation Physiotherapy Digitalization |
| url | https://doi.org/10.1186/s12891-023-06270-8 |
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