Abstract
Moffet H, Collet J-P, Shapiro SH, Paradis G, Marquis F, Roy L. Effectiveness of intensive
rehabilitation on functional ability and quality of life after first total knee arthroplasty:
a single-blind randomized controlled trial. Arch Phys Med Rehabil 2004;85:546–56.
Objective
To evaluate the effectiveness of a new intensive functional rehabilitation (IFR) program
on functional ability and quality of life (QOL) in persons who underwent a first total
knee arthroplasty (TKA).
Design
Randomized controlled trial.
Setting
Ambulatory care.
Participants
Seventy-seven people with knee osteoarthritis.
Intervention
Two months after TKA, subjects were randomly assigned to either a group with IFR (n=38),
who received 12 supervised rehabilitation sessions combined with exercises at home
between months 2 and 4 after TKA, or to a control group (n=39), who received standard
care. All participants were evaluated by a blind evaluator at baseline (2mo after
TKA), immediately after IFR (2mo later; POST1), and 2 and 8 months later (POST2 and
POST3).
Main outcome measures
The primary outcome measure with respect to effectiveness was the 6-minute walk test
(6MWT) at POST2. Secondary outcome measures were the 6MWT at the other evaluations
and the Western Ontario and McMaster Universities Osteoarthritis Index and Medical
Outcomes Study 36-Item Short-Form Health Survey.
Results
Subjects in the IFR group walked longer distances (range, 23–26m) in 6 minutes at
the 3 POST evaluations than subjects in the control group. At POST1 and POST2, they
also had less pain, stiffness, and difficulty in performing daily activities. Positive
changes in QOL in favor of the IFR were found only at POST2.
Conclusions
The IFR was effective in improving the short-term and mid-term functional ability
after uncomplicated primary TKA. The magnitude of the IFR effect on the primary outcome
was modest but consistent. More intensive rehabilitation should be promoted in the
subacute recovery period after TKA, to optimize functional outcomes in the first year
after surgery.
Keywords
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Article info
Footnotes
☆Supported by the Medical Research Council of Canada and Le Fonds de la Recherche en Santé du Québec.
Identification
Copyright
© 2004 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
