Functional Outcomes After Critical Pathway for Inpatient Rehabilitation of Total Knee Arthroplasty
10.5535/arm.2019.43.6.650
- Author:
Jong Hyun KIM
1
;
Bo Ryun KIM
;
Sang Rim KIM
;
Eun Young HAN
;
Kwang Woo NAM
;
So Young LEE
;
Won Bin KIM
Author Information
1. Department of Rehabilitation Medicine, Jeju National University College of Medicine—Regional Rheumatoid and Degenerative Arthritis Center, Jeju National University Hospital, Jeju, Korea. brkim08@jejunu.ac.kr
- Publication Type:Original Article
- Keywords:
Arthroplasty;
Knee;
Osteoarthritis;
Rehabilitation;
Critical pathways
- MeSH:
Arthroplasty;
Arthroplasty, Replacement, Knee;
Critical Pathways;
Exercise;
Female;
Gait;
Humans;
Inpatients;
Knee;
Male;
Ontario;
Osteoarthritis;
Quality of Life;
Rehabilitation;
Torque;
Visual Analog Scale
- From:Annals of Rehabilitation Medicine
2019;43(6):650-661
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To investigate functional outcomes after the application of a critical pathway for inpatient rehabilitation of total knee arthroplasty (TKA).METHODS: A total of 184 patients (57 males and 127 females; average age, 71.5±5.9 years) who underwent unilateral or bilateral TKA were included. The critical pathway included early, intensive individualized rehabilitation exercises. Patients completed the following performance-based physical function tests: the stair climbing test (SCT), 6-minute walk test (6MWT), and Timed Up and Go test (TUG) as well as measurement of isometric knee flexor and extensor strength of the operated knee, gait speed, and range of knee flexion and extension. Self-reported physical function and pain were measured using the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) and visual analog scale (VAS), respectively, and self-reported quality of life was measured using the EuroQoL 5 dimension (EQ-5D) questionnaire. These evaluations were performed preoperatively and at 1 month and 3 months postoperatively.RESULTS: Performance-based and self-reported physical function and quality of life measures improved nonlinearly over time. Specifically, the 6WMT, TUG, gait speed, WOMAC-pain, WOMAC-function, VAS, and EQ-5D scores showed a significant improvement at 1-month post-TKA, whereas SCT, peak torque of the knee extensors and flexors, and WOMAC-stiffness scores showed gradual, but substantial, improvements over 3 months. There were between-group differences (unilateral and bilateral TKA groups) in the time course of the SCT, 6MWT, TUG, VAS, WOAMC-stiffness, and WOMAC-function results.CONCLUSION: Patients who underwent critical pathway rehabilitation after TKA showed significant improvements in functional measurements during the first 3 months post-surgery.
