Authors (including presenting author) :
Chan YM, Au KC, Suen MY
Affiliation :
Department of Physiotherapy, Tin Shui Wai Hospital
Introduction :
There are a growing number of total knee replacement (TKR) operations in NTWC due to the aging population. Studies (Snow et al., 2014) showed the use of preoperative physiotherapy was also associated with a decrease in post-acute care service. A comprehensive prehabilitation program conducted by physiotherapists for total knee replacement (TKR) patients was established in Tin Shui Wai Hospital (TSWH) since July 2017.The program aims to optimize patients’ physical and psychological condition before operation through exercise training and education. This study aims to evaluate the effectiveness of the program on patient outcomes upon discharged from physiotherapy out-patient follow up.
Objectives :
To evaluate the effectiveness of physiotherapy prehabilitation program on outcomes upon discharged from out-patient physiotherapy service
Methodology :
Patients interested in the prehabilitation program were recruited since July 2017. The program incorporated various exercise training, education on the post-operative exercises, walking aids practice and pain relief management. Outcomes including pain level by Numeric Pain Rating Scale (NPRS), Numeric Global Rate of Change Scale (NGRCS), training weeks and sessions attended upon discharged were compared between control group and study group. The outcomes were analyzed by SPSS version 21.0. Mann Whitney U test were used for NPRS, NGRCS, training weeks and sessions attended.
Result & Outcome :
Result:
14 patients discharged from TSWH physiotherapy from July 2017 to June 2018 were recruited, with 6 patients in study group and 8 patients in control group. Compared with control group, study group showed faster walking speed, with fewer training sessions. Walking speed of study group was 0.93 m/sec while that of control group was 0.78 m/sec.
This difference is proven statistically significant which proved better outcome with completing prehabilitation program and may reduce the cost of post TKR rehabilitation.
The control group also required 3 extra out-patient sessions in average compared with the study group which prehabilitation program may reduce the workload of therapist in post-operative phase. This difference is clinically significant, however not proven statistically significant which may be due to the small sample size. Conclusion:
Prehabilitation program may improve outcome of TKR patient upon discharged from out-patient physiotherapy service but larger sample size is needed to prove statistical significance.
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