https://doi.org/10.4081/ejtm.2022.10984
Is group-based physical therapy superior to individual rehabilitation in elderly adults after total knee arthroplasty? A prospective observational study
Submitted: 29 October 2022
Accepted: 16 November 2022
Published: 5 December 2022
Accepted: 16 November 2022
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Knee osteoarthritis (OA) is the most prevalent joint disease and one of the leading causes of disability, poor physical activity levels (PAL), and quality of life (Qol) of elderly people worldwide. The purpose of this study was to evaluate the superiority of a novel group-based physical therapy (GBPT) intervention compared to a more traditional one-to-one individual physical therapy (IPT) among elderly Bulgarian subjects underwent total knee arthroplasty (TKA). One hundred and thirty elderly TKA recipients of both genders with mean age=72.69±0.44 were randomly assigned to GBPT or to one-to-one IPT. Elderly participants were assessed at baseline and at 3 and 6 months after both rehabilitation interventions, with the use of the following evaluation tools: Physical Activity Scale for the Elderly (PASE), Six-Minute Walk Test (6MWT), and Short Form Health Survey questionnaire (SF-36v2). At 6 months elderly TKA recipients who received GBPT achieved 7.36 points more in the PASE questionnaire when compared with the IPT group. Elderly participants of the GBPT group walked significantly longer distance during the 6MWT than TKA recipients attended IPT, respectively 421.56 m vs. 398.62 m, (p< 0.001). Furthermore, significantly greater improvement in health-related quality of life (HRQoL) was obtained from the elderly participants of the GBPT arm compared with the participants of the IPT arm, respectively 70, 7% vs. 60, 8% at 6 months follow up. We conclude that our results suggest the superiority of the GBPT in terms of PAL (PASE score, 6MWT) and HRQoL among elderly TKA recipients across the first 6 months.
NIH census bureau report “An aging world: 2015” Available from: https://www.nia.nih.gov/research /dbsr/global-aging. Accessed October 22, 2022.
Bortoluzzi A, Furini F, Scirè CA. Osteoarthritis and its management - Epidemiology, nutritional aspects and environmental factors. Autoimmun Rev. 2018 Nov; 17(11):1097-1104. Epub 2018 Sep 11.
DOI: https://doi.org/10.1016/j.autrev.2018.06.002
Spitaels D, Mamouris P, Vaes B, Smeets M, Luyten F, Hermens R, Vankrunkelsven P. Epidemiology of knee osteoarthritis in general practice: a registry-based study. BMJ Open. 2020 Jan 20; 10(1): e031734.
DOI: https://doi.org/10.1136/bmjopen-2019-031734
Aprile I, Rizzo RS, Romanini E, De Santis F, Marsan S, Rinaldi G, Padua L. Group rehabilitation versus individual rehabilitation following knee and hip replacement: a pilot study with randomized, single blind, cross-over design. Eur J Phys Rehabil Med. 2011 Dec; 47(4):551-9. Epub 2011 Jun 13.
Sveinsdóttir H, Kristiansen K, Skúladóttir H.Health related quality of life in patients having total knee replacement and associations with symptoms, recovery, and patient education: A six month follow up study. Int J Orthop Trauma Nurs. 2021 Jul; 42:100830. Epub 2020 Nov 2.
DOI: https://doi.org/10.1016/j.ijotn.2020.100830
Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am. 2007 Apr; 89(4):780-5.
DOI: https://doi.org/10.2106/JBJS.F.00222
OARSI. Recommended performance-based tests to assess physical function in people with diagnosed hip or knee osteoarthritis. Available at: http://oarsi.org/sites/default/files/docs/2013/manual.pdf. Accessed October 22, 2022.
Hiyama Y, Kamitani T, Wada O, Mizuno K, Yamada M. Effects of Group-Based Exercise on Range of Motion, Muscle Strength, Functional Ability, and Pain During the Acute Phase After Total Knee Arthroplasty: A Controlled Clinical Trial. J Orthop Sports Phys Ther. 2016 Sep; 46(9):742-8. Epub 2016 Aug 5.
DOI: https://doi.org/10.2519/jospt.2016.6409
Naylor J, Harmer A, Fransen M, Crosbie J, Innes L. Status of physiotherapy rehabilitation after total knee replacement in Australia. Physiother Res Int. 2006 Mar; 11(1):35-47.
DOI: https://doi.org/10.1002/pri.40
Shukla H, Nair SR, Thakker D. Role of telerehabilitation in patients following total knee arthroplasty: evidence from a systematic literature review and meta-analysis. J Telemed Telecare. 2017 Feb; 23(2):339-346. Epub 2016 Jul 9.
DOI: https://doi.org/10.1177/1357633X16628996
Bolszak S, Casartelli NC, Impellizzeri FM, Maffiuletti NA.Validity and reproducibility of the Physical Activity Scale for the Elderly (PASE) questionnaire for the measurement of the physical activity level in patients after total knee arthroplasty. BMC Musculoskelet Disord. 2014 Feb 20; 15:46.
DOI: https://doi.org/10.1186/1471-2474-15-46
Garratt AM, Ruta DA, Abdalla MI, Russell IT. SF 36 health survey questionnaire: II. Responsiveness to changes in health status in four common clinical conditions. Qual Health Care. 1994 Dec; 3(4):186-92.
DOI: https://doi.org/10.1136/qshc.3.4.186
Ko V, Naylor JM, Harris IA, Crosbie J, Yeo AE. The six-minute walk test is an excellent predictor of functional ambulation after total knee arthroplasty. BMC Musculoskelet Disord. 2013 Apr 24; 14:145.
DOI: https://doi.org/10.1186/1471-2474-14-145
Mavrov M. The law institute of patient’s informed consent. Stovi Group Publishers, 2018; 243 pp.
https://www.aaos.org/ Accessed October 22, 2022.
Jakobsen TL, Kehlet H, Bandholm T.Reliability of the 6-min walk test after total knee arthroplasty Knee Surg Sports Traumatol Arthrosc. 2013 Nov; 21(11):2625-8. Epub 2012 May 30.
DOI: https://doi.org/10.1007/s00167-012-2054-y
Naylor JM, Mills K, Buhagiar M, Fortunato R, Wright R. Minimal important improvement thresholds for the six-minute walk test in a knee arthroplasty cohort: triangulation of anchor- and distribution-based methods. BMC Musculoskelet Disord. 2016 Sep 13; 17(1):390.
DOI: https://doi.org/10.1186/s12891-016-1249-7
American Thoracic Society Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002 Jul 1; 166(1):111-7.
DOI: https://doi.org/10.1164/ajrccm.166.1.at1102
Laucis NC, Hays RD, Bhattacharyya T. J Bone Joint Surg Am. 2015 Oct 7; 97(19):1628-34.
DOI: https://doi.org/10.2106/JBJS.O.00030
Clement ND, Weir D, Deehan D. Bone Joint Res. Meaningful values in the Short Form Health Survey-36 after total knee arthroplasty - an alternative to the EuroQol five-dimension index as a measure for health-related quality of life: minimal clinically important difference, minimal important change, patient-acceptable symptom state thresholds, and responsiveness. Bone Joint Res. 2022 Jul; 11(7):477-483.
DOI: https://doi.org/10.1302/2046-3758.117.BJR-2021-0493.R1
Allen KD, Bongiorni D, Bosworth HB, Coffman CJ, Datta SK, Edelman D, Hall KS, Lindquist JH, Oddone EZ, Hoenig H. Group Versus Individual Physical Therapy for Veterans with Knee Osteoarthritis: Randomized Clinical Trial. Phys Ther. 2016 May; 96(5):597-608. Epub 2015 Nov 19.
DOI: https://doi.org/10.2522/ptj.20150194
Levack WMM, Engkasan JP, Heinemann AW, Negrini S.A Review of CONSORT Guidelines About Comparison Groups With a Focused Discussion on Implications for Rehabilitation Clinical Trials. Am J Phys Med Rehabil. 2020 Mar; 99(3):191-197.
DOI: https://doi.org/10.1097/PHM.0000000000001368
Coulter CL, Weber JM, Scarvell JM. Group physiotherapy provides similar outcomes for participants after joint replacement surgery as 1-to-1 physiotherapy: a sequential cohort study. Arch Phys Med Rehabil. 2009 Oct; 90(10):1727-33.
DOI: https://doi.org/10.1016/j.apmr.2009.04.019
Ko V, Naylor J, Harris I, Crosbie J, Yeo A, Mittal R. One-to-one therapy is not superior to group or home-based therapy after total knee arthroplasty: a randomized, superiority trial. J Bone Joint Surg Am. 2013 Nov 6;95(21):1942-9.
DOI: https://doi.org/10.2106/JBJS.L.00964
Tsonga T, Kapetanakis S, Papadopoulos C, Papathanasiou J, Mourgias N, Georgiou N, Fiska A, Kazakos K.Evaluation of improvement in quality of life and physical activity after total knee arthroplasty in greek elderly women. Open Orthop J. 2011; 5:343-7. Epub 2011 Sep 20.
DOI: https://doi.org/10.2174/1874325001105010343
Bennett JA, Winters-Stone K. Motivating older adults to exercise: what works? Age Ageing. 2011 Mar; 40(2):148-9.. Epub 2011 Jan 20.
DOI: https://doi.org/10.1093/ageing/afq182
Munro JF, Nicholl JP, Brazier JE, Davey R, Cochrane T. Cost effectiveness of a community-based exercise programme in over 65-year-olds: cluster randomised trial. J Epidemiol Community Health. 2004 Dec; 58(12):1004-10.
DOI: https://doi.org/10.1136/jech.2003.014225
Enright PL, Sherrill DL: Reference equations for the six-minute walk in healthy adults. Am J Respir Crit Care Med. 1998 Nov; 158(5 Pt 1):1384-7.
DOI: https://doi.org/10.1164/ajrccm.158.5.9710086
Angst F, Benz T, Lehmann S, Aeschlimann A, Angst J.Multidimensional minimal clinically important differences in knee osteoarthritis after comprehensive rehabilitation: a prospective evaluation from the Bad Zurzach Osteoarthritis Study. RMD Open. 2018 Oct 8; 4(2): e000685. e Collection 2018.
DOI: https://doi.org/10.1136/rmdopen-2018-000685
Rossettini G, Testa M. Manual therapy RCTs: should we control placebo in placebo control? Eur J Phys Rehabil Med. 2018 Jun; 54(3):500-501. Epub 2017 Nov 16.
DOI: https://doi.org/10.23736/S1973-9087.17.05024-9
How to Cite
Krumov, J., Obretenov, V., Bozov, H., Tzachev, N., Milanova, H., Panayotov, K., & Papathanasiou, J. (2022). Is group-based physical therapy superior to individual rehabilitation in elderly adults after total knee arthroplasty? A prospective observational study. European Journal of Translational Myology, 32(4). https://doi.org/10.4081/ejtm.2022.10984
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